AKT COPY Flashcards
(1268 cards)
1
Q
Pharm for reducing ETOH effects
A
Naltrexone or Disulfiram (makes you feel worse/crap with ETOH)
2
Q
Pharm to reduce ETOH cravings
A
Acamprosate
3
Q
Post viral URTI with vertigo, hearing loss and tinnitus
A
Labyrinthitis
4
Q
Post viral URTI with vertigo, NO hearing loss and tinnitus
A
vestibular neuronitis
5
Q
Investigation for accoustic neuroma
A
MRI with gadolinium contrast
6
Q
“What bld test to test annually in Down’s?”
A
TSH
7
Q
How long to avoid sexual intercourse post AMI?
A
8 weeks
8
Q
COCP medication components
A
ethinyloestradiol 30mcg levonorgesterol 150mcg
9
Q
Mirena IUD medication component
A
Levonorgesterol 52mg
10
Q
“3 Cx’s of haemachromatosis (systems)”
A
- CLD
- Heart failure (restrictive)
- Arthritis (hands)
11
Q
Gonorrhoea pharm Mx
A
500mg ceftriaxone IM + 1g azithromycin PO stat
12
Q
Gonorrhoea contact tracing
A
2 months
13
Q
Chlamydia test of re-infection
A
3 months
14
Q
Chlamydia test of cure
A
4 weeks - pregnant or rectal chlamydia
15
Q
Chlamydia pharm Rx
A
100mg doxycycline bd 7 days OR
1g azithromycin stat (pregnant)
16
Q
Chlamydia contact tracing
A
6 months
17
Q
Which anti-HTN can inc risk of T2DM
A
Thiazides
18
Q
Which anti HTN causes HIGH calcium
A
Thiazides
19
Q
Which anti HTN causes LOW calcium
A
Loop diuretics (Frusemide)
20
Q
ICS example name and dose
A
Fluticasone proprionate 50mcg - child
125mcg - adult
21
Q
SABA name and dose
A
salbutamol 100mcg
22
Q
ICS/LABA name + dose
A
fluticasone proprionate 50 - 250mcg
salmeterol 25mcg
23
Q
LAMA name + dose
A
tiotropium 5mcg (respimat) daily
24
Q
Metformin eGFR contraindication
A
<30
25
SGLT2 eGFR contraindication
<45
26
DPP4 eGFR contraindication
NONE, just dose adjustment (except linagliptin - no change)
27
Sulphonylureas eGFR contraindication
<30
28
Metformin eGFR reduce dose to 1g?
30-60
29
GLP1 agonist dose
dulaglutide 1.5mg weekly
30
Sulphonylurea + dose
Gliclazide 40mg daily
31
DPP4-i dose
Linagliptin 5mg
32
SGLT2 and dose
Empagliflozin 10mg daily
33
Shockable rhythms
V Fib, V tach
34
Shockable rhythms pharmacology
Adrenaline 1mg after 2nd shock
| Amiodarone 300mg after 3rd shock
35
Non-Shockable rhythms pharmacology
Adrenaline 1mg now, and then every 2nd cycle
36
"4 H's of collapse"
Hypoxia
Hypovolaemia
Hyper/hypokalaemia/metabolic disorders
Hypothermia
37
"4 T's of collapse"
Toxins
Tension pneumothorax
Thrombosis
Tamponade
38
AMI - GTN dose
300-600mcg sublingual every 5mins
Always check BP and avoid in inferior AMI
39
Indications for warfarin for AF Mx
eGFR <30
Valvular AF
(moderate-severe mitral stenosis or mechanical valve)
40
NOAC dose for AF
Apixaban 5mg bd
2.5mg if
At least 2 of:
- 80+ years old
- Weight under 60kg
- Creatine over 133
41
Contraindications to NOAC and warfarin (3)
- Previous intracranial bleed
- Recent GI bleed
- Pregnancy
42
Heart rate aim in AF
<80
43
Beta blocker dose in AF
Atenolol 25mg daily
44
Post AMI driving abstinence duration
2 weeks (private licence)
45
Post TIA driving abstinence duration
2 weeks (private licence)
46
Post CABG driving abstinence duration
4 weeks (private)
47
Post stroke driving abstinence duration
4 weeks (private)
48
2nd degree Type I ECG
Gradually elongating PR until drop (Wenkebach)
not serious
49
2nd degree Type II ECG
PR interval is normal Sudden drop in QRS
Urgent cardio referral
50
CCF - Moderate on exertion (Class)?
Clas III
51
CCF - Mild on exertion (Class)?
Class II
52
CCF - Symptoms at rest (Class)?
Class IV
53
CCF - No symptoms (Class)?
Class I
54
BNP level for CCF
BNP >1800
55
LVEF <35% medication
Ivabradine
56
LVEF <40% medication
ANRI - Entresto
57
Heart Failure Medications + Dose (3)
1. Perindopril 2.5mg daily
2. Spironolactone 25mg daily
3. Bisoprolol 1.25mg daily (2nd line if euvolaemic)
58
HOCM ECG criteria
Deep R waves anterior leads
| Tall Q waves lateral leads
59
Diabetic retinopathy medication and dose
Fenofibrate 145mg daily
60
Tamponade triad
"Beck's"
- Low BP
- Muffled heart sounds, Jugular venous distension
61
Pericarditis meds + dose
Colchicine 500mcg
| (bd if >70kg, daily if <70kg) for 3 months
62
Acute Rheumatic Fever Rx immediate (2)
Benzathine benzylpenicillin IM as a single dose 1.2 million units (adults)
NSAIDs/aspirin
63
Groin Rash DDx (4)
Candida Intertrigo
Tinea Cruris
Flexural Psoriasis
Erythrasma
64
PMHX Melanoma skin checks frequency
- 3 monthly for 2 years
- 6 monthly for 2 years
- 12 monthly for lifetime
65
Cat Scratch Disease Rx
Azithromycin 500mg 1st day, 250mg daily for next 4 days
66
Chickenpox Rx - adults
Adults - Valaciclovir 1g tds 7 days
67
Chilblains Rx
Keep warm
DO NOT RUB/MASSAGE
If extensive or painful:
- Strong topical steroid +/- occlusive dressing (betamethasone dipropionate 0.05% ointment bd)
OR
Severe/recurrent:
- GTN spray
- Nifedipine MR 20mg daily
68
Which infection is linked with Erythema Multiforme?
Herpes Simplex Virus
69
Commonest KNOWN cause of Erythema Nodusum
Sarcoidosis
70
4 causes of LVH
- HOCM
- HTN
- Atrial regurg
- Mitral regurg
- Coarctation aorta
71
Actinic/Solar Keratosis Mx
Spot area = Cryotherapy or Shave + curettage
| Large area = Imiquimod 5% 3xweekly for 4 weeks or Fluorouracil 5% daily for 4 weeks
72
Keratocanthoma Rx
3-5 excisional biopsy
73
SCC Ix
Punch biopsy
74
BCC Ix
Punch biopsy
75
SCC Rx
Superficial = Cryotherapy, shave+curettage, Imiquimod 5% 5xweekly for 6 weeks
Fluorouracil 5% daily for 4 weeks
3D = surgical excision 3-5mm
76
Melanoma Ix
Excisional biopsy 2mm
77
Melanoma Rx
WLE + melanoma unit referral
78
BCC Rx
Superficial = Cryotherapy - double freeze thaw, shave+curettage, Imiquimod 5% 5xweekly for 6 weeks
Fluorouracil 5% daily for 4 weeks
3D = surgical excision 3-5mm
79
BCC typical spread
Locally
80
SCC typical spread
Lymphatics
81
Causes of acne flares (4)
- PCOS
- Humidity
- Occlusive cosmetics
- Drugs - steroids
82
What features to examine when assessing for a burn? (4)
Colour
Blisters
Sensation
Cap Refill
83
Deep dermal burn signs?
Painless
Non-blanching
White/mottled skin
Prolonged cap refill
84
Satellite lesions in skin folds
Candida Intertrigo
85
Candida intertrigo Rx
Clotrimazole 1% cream daily
86
Erysipelas pathogen
strep pyogenes
87
Chondrodermatitis nodularis Rx
Nitroglycerin ointment bd (1–2% glyceryl trinitrate)
88
1st line pharm to increase breastmilk supply
Domperidone
89
Compression mmHg to bandage ulcers
40mmHg
90
Secondary causes of hyperlipidemia (4)
CKD
Hypothyroidism
T2DM
CLD
91
4 contraindications to stress echo
Unstable angina
Severe aortic stenosis
New LBBB
Uncontrolled arrhythmia
92
Lateral STEMI leads + supply
I, AVL, V5, V6
| Left Circumflex artery
93
Inferior STEMI leads + supply
II, III, AVF
| Right Coronary Artery
94
Anterior STEMI leads + supply
V3-V4
| Left Anterior Descending
95
Septal STEMI leads + supply
V1-V2
| Left Anterior Descending
96
Posterior STEMI leads + supply
V7-V9
| Right Coronary Artery
97
Contraindications to performing Valsalva's for SVT (4)
AMI
Haemodynamic instability
Aortic stenosis
Glaucoma
98
Takotsubo Cardiomyopathy Rx
ACEi or beta blockers until resolved systolic dysfunction ~ 1 month
99
Dandruff 1st line Rx
Selenium sulphide shampoo
100
Discoid Eczema Rx
Strong steroid (betamethasone diproprionate 0.05% daily for 2 weeks)
101
What disease is dermatitis herpetiformis linked with?
Coeliac disease
102
Dermatofibroma distinctive features (2)
```
Pale centre
Pinch sign (central dimple)
```
103
Rash with target lesions
Erythema Multiforme
104
Treatment of Erythema Multiforme
Treat Cause, but otherwise self resolves
- Aciclovir for HSV
- ABx for mycoplasma pneumoniae
105
ASTI smoking screening age
10
106
ATSI fasting T2DM check age
18
107
ATSI BP, UEC check age
18
108
Coral pink fluorescence under wood lamp
Erythrasma
109
Erythrasma Rx
Fusidate sodium 2% ointment bd for 14 days
110
Red swollen fingers+toes, linked with T2DM
Erythromelalgia
111
Itch/pain/burning rash in sun-exposed skin
Exercise-induced vasculitis or Golfer's vasculitis
112
Exercise-induced vasculitis or Golfer's vasculitis Rx
Self-resolving in 3-4 weeks
113
Folliculitis causative pathogens
Bacterial - Staph aureus, Pseudomonas aeruginosa
| Fungi
114
Folliculitis Rx
Treat according to swab MCS
| - commonly - flucloxacillin or cephalexin 500mg QID
115
Rash with firm papules "string of pearls" ring
Granuloma Annulare
116
Granuloma Annulare associated conditions (3)
T2DM
Hyperlipidemia
Autoimmune Thyroiditis (children)
117
Granuloma Annulare Rx
Strong steroid (betamethasone diproprionate 0.05% daily for 2 weeks)
118
Grover's Disease Rx
Strong steroid (betamethasone diproprionate 0.05% daily for 2 weeks)
119
Spotty itchy rash in children (trunk) sparing hands/feet?
Guttate psoriasis
| - linked with strep infection
120
Telogen Effluvium triad
- Stressful event
- 2-3 months to diffuse hair loss
- white bulbs
(Pull test = hair coming out)
121
Hair loss with chemo/radiotherapy
Anagen Effluvium
122
Exclamation mark hairs
Alopecia Areata
123
Androgenetic Alopecia Rx
- Minoxidil to dry scalp - for 12+ months (not for females)
| - Finasteride for 2+ years - halts balding process (SE gynaecomastia)
124
What virus is associated with Hand, Foot & Mouth Disease?
Coxsackie virus
125
Management of Hand Foot & Mouth (2)
- Supportive, fluids (can become dehydrated)
| - Keep home until blistered have dried/crusted
126
Herpes Simplex Virus Type I management?
First sensation - Aciclovir 5% cream 5 times daily for 5 days
Severe - Aciclovir 400mg tds for 5 days
127
Post-herpetic Neuralgia Rx (3)
1. Simple analgesia/Ice massage
2. Lidocaine 5% patch,
3.
Amitriptyline 10–25 mg nocte
Gabapentin 300 mg nocte
128
Shingles Rx
Valaciclovir 1g tds for 7 days
129
Impetigo NON-PHARM Rx
- Keep away until 24hrs after starting Abx
| - Cover wounds
130
Impetigo Rx (non-endemic) + multiple sores
- Flucloxacillin 12.5 mg/kg up to 500mg QID 7 days.
| - Keep away until 24hrs after starting Abx
131
Impetigo Rx (Endemic)
- Benzathine benzylpenicillin IM 1.2 million units
| - Keep away until 24hrs after starting Abx
132
Impetigo Rx (non-endemic) + localised sores
- Mupirocin 2% ointment tds for 5 days
133
Impetigo Rx (penicillin allergy)
- Trimethoprim + sulfamethoxazole, bd for 3 days
| - child 4/20mg/kg up to 160/800mg
134
Bullous Impetigo pathogen
Staph aureus (infectious!)
135
Bullous Impetigo Rx
- Flucloxacillin 500mg QID for 7 days
| - Do not share towels with other family members
136
Keratosis Pilaris Rx
- Topical retinoids, salicyclic acid
137
Lichen Planus Rx
- Symptomatic - potent steroid (beta. dip 0.05%)
| - Otherwise resolves in a few months
138
Molluscum Contagiosum causative pathogen
Pox virus
139
Nappy rash Rx
Dependent on cause
| hydrocortisone 1% + nystatin 100 000 units BD or clotrimazole
140
Molluscum Contagiosum Rx
Self Resolves
141
Nappy rash causes (3)
Irritant dermatitis
Candida
Seborrheic dermatitis
Psoriasis
142
Nappy rash Rx
Dependent on cause
| hydrocortisone 1% + nystatin 100 000 units BD
143
Lump with buttonhold invagination when pressed?
Neurofibroma
144
Perioral dermatitis Rx
Doxycycline 100mg daily for 8 weeks
145
Tiny black pits in soles of feet (Pitted Keratolysis) Rx?
Clindamycin 1% bd for 10 days
146
Pityriasis Rosacea Rx?
- Self-limiting - 6-8 weeks
| - Use corticosteroid cream for itch
147
Pityriasis Versicolor Rx (2)
selenium sulfide shampoo 2.5% for 10 days
OR antifungal creams
Apply to wet skin and leave on for 10 mins
If ineffective, flucanozole 400mg oral stat
148
Pyogenic Granuloma Rx (1)
Imiquimod 5% 5xweekly for 6 weeks vs excision
149
Rosacea Non-pharm Rx (4)
Cleanser + moisturising routine
SPF 30+
Trigger avoidance
Avoid perfumes/colognes
150
Rosacea Pharm Rx (3)
1. Topical metronidazole
2. Azelaic acid
3. Doxy 100mg daily 8 weeks
151
Scabies Rx
Permethrin 5% cream from jawline downwards overnight
| Repeat in 1 week
152
Scarlet fever causative pathogen
Strep Pyogenes
153
Lace-like/sandpaper rash
Scarlet Fever
154
Scarlet Fever Rx
Phenoxymethylpenicillin 500mg bd for 10 days
155
Seborrhoeic Dermatitis (infants) Rx
Salicylic acid 2% + LPC (liquor picis carbonis = coal tar solution) 2% + sulfur 2%
156
Which tinea locations need oral terbinafine?
| What dose?
Scalp, nails or widespread
250mg oral terbinafine daily
Toenails = 12 weeks
Fingernails = 6 weeks
157
Which tinea locations need topical terbinafine?
Everywhere except scalp/nails
1% terbinafine cream bd 2 weeks
158
Venous Ulcer appearance
Ragged edge, slight pain, slough
159
Arterial Ulcer Appearance
Punched out, Pain +++, Cold. Relieved by hanging out of bed
160
Lump with buttonhold invagination when pressed?
Neurofibroma
161
Diabetic/Pressure Ulcer Mx (3)
Clean base with saline
Relief of friction
Iodosorb ointment/Foam dressing
162
Pityriasis Rosacea Rx?
- Self-limiting - 6-8 weeks
| - Use corticosteroid cream for itch
163
Pityriasis Versicolor Rx
selenium sulfide 2.5% for 10 days
Apply to wet skin and leave on for 10 mins
164
Rosacea Non-pharm Rx (4)
Cleanser + moisturising routine
SPF 30+
Trigger avoidance
Avoid perfumes/colognes
165
Rosacea Pharm Rx
1. Topical metronidazole
| 2. Doxy 100mg daily 8 weeks
166
T2DM assessment for low risk asymptomatic patients.
- AUSDRISK >40yo
167
Scarlet fever causative pathogen
Strep Pyogenes
168
Lace-like scarlet rash
Scarlet Fever
169
Scarlet Fever Rx
Phenoxymethylpenicillin 500mg bd for 10 days
170
Seborrhoeic Dermatitis (infants) Rx
Salicylic acid 2% + LPC (liquor picis carbonis = coal tar solution) 2% + sulfur 2%
171
Which tinea locations need oral terbinafine?
| What dose?
Scalp, nails or widespread
250mg oral terbinafine daily
Toenails = 12 weeks
Fingernails = 6 weeks
172
Requirements for HbA1c to diagnose T2DM
> 6.5% on TWO occasions
173
Causes of low HbA1c
Anaemia
Haemoglobinopathies
CKD
174
Requirements for OGTT to diagnose T2DM
(EITHER)
Fasting >7
2 hours >11
175
Neuropathic Ulcer Location
Plantar surface (pressure areas), well demarcated
176
What to examine for with foot ulcers (3)
- Sensation with 10gm monofilament
- Ankle Brachial Index Measurement
- Dorsalis Pedis/Posterior Tibialis pulse
177
T2DM Driving license with insulin
2 yearly license review +/- conditional
178
Arterial Ulcer Mx
Urgent vascular surgeon review for reperfusion
179
Diabetic/Pressure Ulcer Mx (3)
Clean base with saline
Relief of friction
Iodosorb ointment/Foam dressing
180
Urticaria Rx
Loratadine 10mg daily
181
Who needs annual screening for T2DM? (FBGL) (2)
Prediabetes
| ATSI
182
T2DM assessment for low risk asymptomatic patients.
- AUSDRISK >40yo
183
FBGL intermediate range
5.5-6.9
Mx = perform HbA1c or OGTT
184
HbA1c intermediate range
6.0-6.4%
Mx = retest in one year
185
OGTT results for Impaired glucose tolerance
Fasting: <7 mmol/L
| 2 hour : 7.8 - 11 mmol/L
186
OGTT results for Impaired fasting glycaemia
Fasting glucose: 6.1-6.9
| 2 hour glucose < 7.8
187
Addison's Ix
Short Synacthen test
○ Gives synthetic ACTH, should normally increase cortisol
○ In Addison's (underfunctioning adrenal), there is no increased cortisol - positive test
188
Requirements for HbA1c to diagnose T2DM
> 6.5% on TWO occasions
189
Causes of low HbA1c
Anaemia
Haemoglobinopathies
CKD
190
Requirements for OGTT to diagnose T2DM
(EITHER)
Fasting >7
2 hours >11
191
OGTT results to Dx GDM
Fasting glucose >5.5 (reduce by 1.5)
| Two hour glucose >8.0 (reduce by 3.0)
192
T2DM Driving license with OHA's
5 yearly license review +/- conditional
193
T2DM Driving license with insulin
2 yearly license review +/- conditional
194
Which diabetic patients need conditional licenses (4)
- Severe hypoglycaemia
- Acute hyperglycaemia
- End-organ damage
- Commercial drivers on OHA's/insulin - specialist review
195
Pre-exercise BGL range for T2DM
5 - 13.9
196
How often to check BGL during exercise if on insulin or sulfonylureas
30-45 minutes
197
How long after exercise can you get hypoglycaemia with SU's/insulin?
48 hours
198
Fasting BGL aim in T2DM
4-7
199
2 hour post-prandial BGL aim in T2DM
5-10
200
Severe hypoglycaemia event, driving restriction
6 weeks until stabilised by specialist
201
Late Onset Autoimmune Diabetes Ix (4)
- glutamic acid decarboxylase (GAD) antibodies
- insulinoma antigen-2 (IA2) antibodies
- islet cell antibodies
- Insulin antibodies
202
How often to get eye Ax with T2DM?
24 monthly
| 12 monthly if - ATSI, systemic disease, >15 years Dx, poor control
203
What T2DM meds to cease on sick days or if BGL >15 on two occasions
Metformin, SLGT2 (dehydration risk)
204
Acromegaly Ix
IGF-1 - insulin-like growth factor
205
Carcinoid Syndrome Ix
24 hr urine 5-hydroxyindoleacetic acid
206
Conn's syndrome Ix
Plasma aldosterone-renin ratio
207
Cushing's Syndrome Ix (3)
- Overnight 1mg dexamethasone suppression test
- 2 measurements of late night salivary cortisol
- 2 measurements of 24 hour urinary - free cortisol excretion
208
Diabetes Insipidus triad
Weakness + Massive Polyuria + Polydipsia
209
Diabetes Insipidus Rx
desmopressin intranasally bd
210
DKA BGL and ketones diagnosis
BGL>11mmol/L and ketones > 0.6mmol/L
211
Hyperosmolar Hyperglycaemic State BGL and ketones diagnosis
BGL >30mmol/L and ketones anything
212
Mild hypoglycaemia Mx (BGL <4.0)
15 rule
- 15g of sugar (half fruit juice glass)
- Recheck in 15 mins
- Test every hour for next 4 hours
213
Severe hypoglycaemia Mx (reduced GCS)
Glucagon 1g IM stat
OR
Dextrose 50% 20mL
214
Severe hypoglycaemia event, driving restriction
6 weeks until stabilised by specialist
215
When to assess risk for OP
- Annually in post-menopausal women or men >50yo
216
T1DM Ix (2)
- Glutamic acid decarboxylase (GAD)
| - Insulinoma antigen-2 (IA-2) antibodies
217
Osteopenia Dx
-1 to -2.5 T score
218
Osteoporosis Dx
Less than -2.5 T score
219
What Z score to be concerned for secondary causes
Less than -2.0 score
220
After starting carbimazole, when to recheck TFT's and adjust dose?
4-6 weeks
221
Bisphosphonate dose
Alendronate 70mg oral weekly
222
Denosumab dose
60mg subcut 6 monthly
223
When to stop osteoporosis Rx?
5-10 years of Rx without any fractures and BMD >-2.5
224
Osteoporosis new medication. When to review?
6 months
225
Osteoporosis pt monitoring. When to review?
12 months
226
Osteoporosis pt monitoring. When to DEXA?
2 yearly
227
Non-osteoporotic, high-risk pt. When to review?
2-5 years (including DEXA)
228
Which medication to use in CKD + osteoporosis
Denosumab
229
Phaeochromocytoma Ix
24 hour urine metanephrines/catecholamines test
230
SIADH Ix (3)
- Urine osmolality >100
- High urinary sodium
- Low blood sodium (dilution)
231
SIADH Mx (1)
Fluid restriction <800mL/day
232
T1DM Ix (2)
- Glutamic acid decarboxylase (GAD)
| - Insulinoma antigen-2 (IA-2) antibodies
233
Imaging of choice for goitre with Hyperthyroidism (uptake)
Thyroid Scintigraphy scan
234
Imaging for goitre with Hypothyroidism
Trial levothyroxine and check if nodule regresses first
If not, consider ultrasound
235
Drugs that can cause hypothyroidism (2)
Lithium, amiodarone (also hyper)
236
Graves Ix
Anti TSH Receptor Antibodies
237
Hashimoto's thyroiditis Ix
anti-TPO (anti-thyroid peroxidase antibodies)
| also elevated in thyroiditis
238
Hyperthyroidism Rx
Carbimazole 10-15mg bd
239
After starting carbimazole, when to recheck TFT's and adjust dose?
4-6 weeks
240
When to use PTU instead of carbimazole?
Pregnancy, Thyroid storm, Preconception
Multiply CBZ dose by 10 to get PTU dose
241
Most important SE of carbimazole/PTU?
Agranulocytosis
Cease if febrile or pharyngitis
242
Subclinical asymptomatic hypothyroidism Mx
Repeat TFT's in 6 weeks. Commence thyroxine if:
1. TSH >10
OR
2. Thyroid peroxidase antibody
243
When to consider partial hypothyroid replacement?
| 25-50mcg daily
- Elderly
- High CVD risk
- Subclinical (where TSH >10 on retesting)
244
Hypothyroidism Rx dose
levothyroxine 1.6mcg/kg daily (to nearest 25mcg, (50-100mcg
245
Thyroiditis Rx
- propranolol 10mg bd if symptomatic
- Repeat TFT's in 6 weeks
- If painful - NSAID's too
246
Allergic Rhinitis Examination signs (3)
- turbinate hypertrophy
- pale blue nasal mucousa
- Suborbital oedema
247
Oral thrush Rx
Under 2yo = 100 000 units nystatin 1mL QID for 1 week
| Over 2yo = Micanozole 2% gel, 2.5mL QID 1 week
248
Imaging of choice for cholesteatoma
CT temporal bone
249
Examination findings of Infectious Mononucleosis (3)
- Splenomegaly
- Hepatomegaly
- Jaundice
- Rash
250
Meniere's Disease Triad
Vertigo, tinnitus, hearing loss - Unilateral
251
Meniere's Disease Mx (3)
- Limit salt <2g/day, ETOH, caffeine,
- Vestibular rehab
- Prochlorperazine 10mg daily
- Hydrochlorothiazide 25mg daily
252
What age to refer Nasolacrimal duct obstruction to opththal
>12 months of age
253
Otitis Media risk factors (3)
- Smoking exposure
- Childcare
- Down's syndrome
- Adenoid disease
254
Otitis Media ABx
Amoxicillin 15mg/kg tds for 5 days
Review in 48 hours
255
Otitis Media ABx if not improving with amoxi
If not improving in 48 hours,
Augmentin DF 875/125 bd for 5 days
256
Otitis Media ABx if allergic to penicillin
Cefuroxime 500mg bd for 5 days
257
Recurrent AOM criteria and Rx
3+ episodes in 6 months and need to be <2yo
amoxicillin 25mg/kg bd for 6 months
258
Glue ear (AOM with effusion) Mx?
- Tend to self drain in 4 weeks
| - Refer if >3 months, or if causing hearing issues
259
Chronic Suppurative Otitis Media Dx criteria
>6 weeks of perforated TM with discharge
260
Chronic Suppurative Otitis Media Mx (3)
- Ear toileting (rolled tissue spear QID until ear dry)
- Ciprofloxacin 0.3% ear drops (x5) bd until discharge free for 3 days
- Refer to audiology for hearing assessment
- ENT referral
261
Grommets +/- adenoidectomy indications (2)
- Chronic otitis media (>3 months) with effusion and hearing loss
- Recurrent otitis media with effusion
262
Otitis Externa Mx (3)
- Sofradex ear drops - 3 drops tds for 7 days
- Paracetamol 15mg/kg QID PRN
- Dry aural toileting QID PRN until canal is dry
263
Otitis Externa prevention (2)
- Aqua-Ear after water exposure
| - Keep ear-dry, use earplugs or bathing cap during showering/swimming
264
Otosclerosis - what bone does it affect?
Stapes
265
Otosclerosis Mx (1)
- Referral to ENT for stapedectomy
266
Perforated TM broad causes (3)
Infection, trauma, growths
267
Safe perforated TM Mx (3)
- Dry toileting with tissue spear
- Self-resolving in 4 weeks
- Amoxicillin 500mg tds for 5 days if infected
268
Antibiotic indications for rhinosinusitis (3)
- Discoloured purulent discharge
- 38oC
- Severe localised pain
269
Sialoliths Mx (2)
- Conservative with massage and analgesia, warm liquids
| - Infected = 7 days Flucloxacillin 500mg QID
270
Tonsillectomy Indications
Tonsillectomy Indications (6-4-2, 1-2-3 rule)
- 6+ episodes/year for more than 1 year
- 4+ episodes/year for more than 2 years
- 2+ episodes/year for more than 3 years
271
When to treat tonsillitis with ABx?
- Bacterial likely
- Immunosuppressed
- Previous complications
- ATSI
272
Bacterial tonsillitis Rx
Phenoxymethylpenicillin 500mg bd for 10 days
Penicillin allergy - azithromycin 500mg daily for 5 days
273
Vestibular Neuronitis Rx (1)
- Prednisolone 1mg/kg (up to 75mg) for 5 days
274
Anal fissure Mx? (4)
- Topical lignocaine
- Treat constipation - stool softeners, high fibre diet
- Sitz bath
- Topical GTN/diltiazem
- Local injection of botox
275
Bowel cancer 4 flag criteria for moderate risk
First degree relative <55yo (4)
First degree relative >55yo (2)
Second degree relative any age (1)
276
If moderate risk bowel cancer, screening?
FOBT every 2 years from 40-49
Colonoscopy every 5 years from 50-74
Aspirin 2.5 years from 50-74yo
277
If high risk bowel cancer, screening?
(Reduce age points by 5 years compared to mod risk)
Refer to family cancer clinic
FOBT every 2 years from 35yo
Colonoscopy every 5 years from 45-74yo
278
Medication for liver cirrhosis from portal HTN
carvedilol
279
Risk factors for coeliac disease (3)
Hypothyroidism
T1DM Diabetes
Autoimmune thyroid disease
Down's syndrome
280
Diverticulitis non-severe attack Mx (3)
- Clear liquids for 2-3 days
- Amoxicillin + clavulanic acid 875/125mg bd for 5 days
- Penicillin allergy = Trimethoprim + sulfamethoxazole 960mg bd AND metronidazole 600mg bd 5 days
281
Gastro in nursing home. When to notify public health unit
- 2+ more residents
282
ABx indications for gastro (3)
- Septic
- Immunocompromised
- Salmonella or severe C.Diff (all other bacterial causes don't require Abx)
283
When do you avoid loperamide for gastro? (3)
○ Children
○ Bloody diarrhoea
○ High fever
- Systemic symptoms
284
Lifestyle Mx for GORD (4)
- Avoid spicy food
- Remain upright after eating
- Weight loss
- Stop smoking
285
Urea Breath Test preparation advice (3)
- No Abx for 4/52
- No PPI for 2/52 before test
- Nil water in morning
- Nil brushing teeth
286
H. Pylori Rx (3)
HP7 treatment. ACE - all given BD
- Amoxicillin 1g (metronidazole 400mg bd if hypersensitive)
- Clarithromycin 500mg
- Esomeprazole 20mg
287
When to repeat UBT post H.Pylori Rx
4 weeks
288
Haemochromatosis Ix
Elevated transferrin + ferritin
289
Typical arthritis region for haemochromatosis
MCPJ 2nd/3rd joint
290
Hep A Mx
- Self limiting - 6 weeks
- Avoid fats, ETOH, panadol and smoking
- Wash hands, do not share cutlery
291
surface antigen
surface antibody
core antibody
Acute Hep B
POSITIVE surface antigen
NEGATIVE surface antibody
POSITIVE core antibody
292
surface antigen
surface antibody
core antibody
Chronic Hep B
POSITIVE surface antigen
NEGATIVE surface antibody
POSITIVE core antibody
293
surface antigen
surface antibody
core antibody
Vaccinated Hep B
NEGATIVE surface antigen
POSITIVE surface antibody
NEGATIVE core antibody
294
surface antigen
surface antibody
core antibody
Resolved Hep B
NEGATIVE surface antigen
POSITIVE surface antibody
POSITIVE core antibody
295
When does Hep C Mx need referring to specialist? (2)
- If HIV/HBV co-infection
| - Cirrhosis present
296
When does Hep C Mx need referring to specialist? (2)
- If HIV/HBV co-infection
| - Cirrhosis present
297
Assessment of cure for Hep C
- Hepatitis C RNA PCR and LFT's at 12 weeks post treatment
298
IBD - pain before defecation?
Crohn's
299
IBD commonly blood and mucous stools
Crohn's
300
IBS Mx (4)
- Regular meal times
- Avoid triggers
- Low FODMAP diet
- Referral to dietitian
- Referral to psych for CBT
301
NAFLD Ix diagnosis
- AST and ALT >2x ULN
- AST/ALT < 1
- Needs USS/MRI/Imaging
302
NASH monitoring
6 monthly liver US +/- AFP
303
NAFLD Mx
Cirrhosis/NAFLD fibrosis score high = gastro referral, fibroscan +/- biopsy
NAFLD fibrosis score Low = manage risk factors
304
NAFLD Monitoring
6 monthly LFT's
305
NASH monitoring
6 monthly liver US +/- AFP
306
Acute Pancreatitis Ix (Dx)
Lipase >3 UNL
307
Acute Pancreatitis Mx
- ED Mx for IV hydration due to high mortality
308
PBC or PSC
| Males commonly
PSC
309
PBC or PSC
| Linked with Ulcerative colitis
PSC
310
PBC or PSC
| Female
PBC
311
PBC and PSC symptoms (4)
- Abdo pain
- Fever
- Fatigue
- Pruritis
- Jaundice
312
PBC or PSC
| Colorectal cancer risk
PSC
313
PBC or PSC
| Intrahepatic ducts only
PBC
314
Dx, pain in throat with cold/hot food
Oesophageal spasm
315
Gastric peptic ulcer. Pain after eating time frame?
Pain 30 mins after eating
316
Dudodenal peptic ulcer. Pain after eating time frame?
Relieved when eating, Pain starts 2-3 hours later
317
External haemorrhoids difference
Painful
| Visible/palpable lump on outside
318
What type of haemorrhoids is treated with banding?
Internal
319
External haemorrhoids difference
Painful
| Visible/palpable lump on outside
320
When can you break consent? (4)
- Patient permission
- Mandatory by law
- Necessary discussion with other health professional
- Duty to public health
321
What age to screen smoking in ATSI?
12yo
322
What age screen CVD (risk calculator)
45+ yo (ATSI >30yo)
323
Adrenaline dose for anaphylaxis in children
0.01mL/kg every 5 mins
324
My Aged Care referral criteria
>65yo or >50 with homelessness/complex needs
325
Disabled Parking criteria
- Sig mobility deficit
- Sig neuro/cognitive deficit
- Standard parking bay is not big enough for equipment
326
Varenicline CI's
Psychosis, suicidal thoughts, CVD, pregnancy/BF
327
Smoking cessation - Champix dose
Varenicline - 0.5mg for 3/7 -> 0.5mg BD for 4/7, then 1mg BD for 12/52
328
Smoking cessation 3 options (Rx)
Nortriptyline
Varenicline
Bupropion
329
NRT dosing
>12yo - 10+ cigs or smoking within 30 mins wake up
▪ 21mg/24hr patch >45kg
▪ 14mg/24hr patch <45kg
Quick acting = 2mg chewable every 2 hours
330
NO false negatives = what statistical term
100% sensitivity
331
NO false positives = what statistical term
100% specifiicity
332
What helps to rule out disease (sensitivity or specificity)
SNOUT - Sensitive tests, where negative helps rule OUT
333
What helps to rule out disease (sensitivity or specificity)
SNOUT - Sensitive tests, where negative helps rule OUT
334
How to calculate number needed to treat?
1/Absolute risk increase
335
Incidence definition
number of new cases
336
Prevalence definition
number of exisiting cases
337
1st line investigations for easy bruising (4)
○ FBE + blood film
○ APTT
○ PT/INR
- Fibrinogen
338
Pernicious anaemia Rx (1)
IM 1mg hydroxocobalamin every second day for 2 weeks
and lifelong:
1 mg hydroxocobalamin IM every 3 months
339
Pernicious anaemia Rx (1)
IM 1mg hydroxocobalamin every second day for 2 weeks
and lifelong:
1 mg hydroxocobalamin IM every 3 months
340
Iron deficiency Rx (1)
100mg elemental iron daily for 3 months
341
Assessment for DVT?
Well's score
Low = D dimer
High = Venous doppler of affected
342
DVT Mx
Apixaban 10mg bd for 7 days, then 5mg bd for 3 months
Except if pregnant or eGFR <30
343
Lymphoma's how to diagnose
Excisional biopsy only
344
CRAB criteria multiple myeloma
Calcium - elevated
Renal - uremia
Anaemia
Bones - pain and fractures
345
Risk Factors for temporal arteritis (3)
Female
Age >50yo
PMR
346
Rotavirus vaccine age cutoff
1st dose by 14 weeks, 2nd dose by 24 weeks
347
Live vaccines CI (2)
○ Cancer patients on immunosuppressive therapy (e.g RTx/CTx)
High dose immunosuppressive therapy (>90mg pred/day or >2mg/kg children)
Pregnancy
348
Meningococcal B dosage for age groups
6 weeks – 12 months, 3 doses
| 12+ months, 2 doses
349
Pneumococcal ages for people who are well
70+yo
| ATSI 50+yo
350
Shingles vaccine age
Recommended 60+, but anyone 50+ can request
351
Influenza dosing
- 6 months – 9yo need two doses 4 weeks apart only if first ever influenza vaccine
352
What vaccines can you not give for egg allergy (2)
Yellow Fever
| Q fever
353
Causes of vaccines not working in patient (3)
- Expired vaccine given
- Cold chain breach of vaccine
- Manufacturing defect of vaccine
- Individual's immune response was ineffective
354
Malaria Prophylaxis (1)
PROMOZIO start 2 days before continue 7 days after
OR
Doxycycline 100mg daily 2 days before, 4 weeks after
355
Fever + rash, travelled to NSW
Barmah Forest Virus
356
Fever, been with sheep and pigs
Brucellosis
| Bruce Willis looks like sheep/pig
357
Fever, SE asia, retroorbital pain
Dengue Fever
358
Dengue Fever Mx
Conservative Mx, advise about possible risk of haemorrhage and shock
359
Giardia symptoms (2)
- Steatorrhoea
- Anorexia/LOW
- Fatigue
360
Giardia Rx (1)
- Metronidazole 400mg tds for 5 days
361
Fever, stupor, vomiting, returned from overseas
Japanese B Encephalitis
362
Fever, conjuncitivitis, headache, farmer
Leptospirosis
EPT = PET = Farmer pets
Or meat industry
363
Gastro symptoms after someone had poorly stored milk
Listeriosis
Li for milk
364
Listeriosis Rx (1)
Amoxicillin 1g tds for 2 weeks (pneumonia)
365
Leptospirosis Rx (1)
Doxycycline 100mg 7 days
366
Malaria Ix (1)
Thick and thin blood films for 3 days (initial may be too early to detect)
367
Malaria Examination findings (3)
Splenomegaly
Conjunctival changes
Cervical lymphadenopathy
368
Resp infection caught by birds
Psittacosis
369
Weakness, fever, abbatoir worker
Q fever
370
Q fever Rx (1)
- Usually spontaneously resolves in 2-6 weeks
- Doxycycline 100mg bd for 14 days
Can do Q fever vaccines for those at high risk
371
Insect bite, Queenslander
Queensland Tick Typhus
372
Queensland Tick Typhus Rx (1)
Doxycycline 100mg bd for 7 days
373
Painful animal bite + pain with drinking
Rabies
374
Rabies Rx
Vaccinate, even if after bite
375
Farmer, sparse spotty rash, fever
Ross River Virus
376
Parasitic worms in - Sub-Saharan Africa, the Middle East, Southeast Asia and the Caribbean
Schistosomiasis from contaminated faeces
377
Cat litter and contaminated/uncooked food
| Fever, muscle aches
Toxoplasmosis
378
Traveller's diarrhoea Rx
azithromycin 1g oral stat
379
Gradually worsening fever and abdo fever in returned traveller
Typhoid
380
Typhoid Rx (1)
Azithromycin 1g oral daily for 7 days
381
Eschar rash - Transmitted through bites, Asia
Typhus
382
Typhus Rx (1)
- Doxycycline 100mg bd
383
Anal warts Rx (1)
Podophyllotoxin 0.15% cream bd for 3 days, then nothing for 4 days. Repeat x4
384
Hairy leukoplakia is a sign of?
HIV
385
Time frame for post-exposure HIV prophylaxis
Within 72 hours of exposure
386
How long to take PrEP for HIV until covered
Males - 7 days
| Females - 20 days
387
Exposure to influenza, but negative result Mx (1)?
Vaccinate
388
Influenza Rx (1)
Oseltamivir up to 75mg bd for 5 days
389
What Ix to do for needlestick injury (3)
- Hep B (anti-HBs, HBsAg)
- Hep C (anti-HBc IgG, Hepatitis C serology HCV RNA PCR)
- HIV serology
390
When to repeat testing for needlestick injury?
3 and 6 months
391
Indications for tetanus booster after injury
>5 years since last dose + DIRTY or MAJOR wound
392
Indications for tetanus immunoglobulin after injury
Not completed 3 course of tetanus + DIRTY or MAJOR wound
393
Primary syphillis symptom (1)
Painless ulcer (Chancre)
394
Secondary syphillis symptom (1)
Rash
395
Tertiary syphillis symptom (1)
Systemic paralysis
396
Acute syphillis infection Ix (1)
- Syphillis Rapid Plasma Reagin (RPR) testing AND enzyme Immunoassay
This is also used for test of cure in 3, 6, 12 months
397
Chronic syphillis infection Ix (1)
Enzyme Immunoassay (EIA), positive for lifetime
398
Syphillis chancre investigation (1)
NAAT swab of ulcer
399
Rash, fever and myalgia after syphilis treatment?
Jarisch-Herxheimer reaction
400
Syphilis Rx (1)
Benzathine benzylpenicillin 2.4 million units IM injection stat
Pen allergy - Doxycycline 100mg bd for 14 days
401
Duration of therapy for provoked, distal DVT
6 weeks +
402
Duration of therapy for unprovoked DVT
3 months +
403
Duration of therapy for proximal DVT
3 months +
404
What is Pott's disease?
MSK TB (TB in spine)
405
Tuberculosis Ix for acute disease (1)
- Sputum acid-fast bacilli smear x3
406
Tuberculosis Ix for chronic disease (1)
- Quantiferon Gold (does not check for active disease)
407
Prostate cancer screening age
- Offer 50-69yo every 2 years
- Offer 45-69yo every 2 years if risk factors
Even if high risk, controversial with screening
408
Prostatitis empirical Rx
Trimethoprim 300mg daily for 14 days
409
Epididymo-orchitis causes (4)
Mumps
Urinary source
STI source
Amiodarone
410
Epididymo-orchitis examination specific finding (1)
Prehn's sign - relief of pain upon lifting of scrotum
Ehn happening to me - BXO
411
Blue dot sign
Torsion of testicular appendage
412
Indirect hernia vs Direct hernia
Common in young
Indirect
413
Indirect hernia vs Direct hernia
Can descend into scrotum
Indirect
414
Indirect hernia vs Direct hernia
Medial to inguinal vessels
Direct
415
Balanitis Rx
Canesten (1% clotrimazole) bd for 7 days after symptoms resolve
416
Peyronie's disease associated conditions (3)
HTN
T2DM
Obesity
417
When to Rx Peyronie's disease
- Only if causing pain or sexual interference
1. Surgical
2. Injections - collagenase
418
Erectile Dysfunction Rx (1)
Sildenafil 50mg PRN (max 1/day)
| - Have on empty stomach
419
Erectile Dysfunction non-pharm Mx (3)
- Quit smoking
- Exercise
- Avoid ETOH/caffeine
- Weight loss
- Psychology
420
Premature Ejaculation Rx (2)
1. Topical anaesthetic to penile shaft (lignocaine)
| 2. Dapoxetine 30mg 1-3 hours before intercourse
421
SPC monitoring Ix (2)
Yearly:
1. bladder USS
2. UEC's
422
When to use triangular sling?
supports elbow - for fractures where traction would make it worse
E.g AC joint or clavicle # SNOH
423
When to use collar + cuff sling?
- when you need traction for fracture to heal
| Humerus shaft, shoulder dislocation (internal rotation)
424
Shoulder dislocation Mx (1)
Collar and cuff
425
AC joint dislocation Mx (1)
Triangular sling (clavicle traction isn't good)
426
Humerus fractures Mx (1)
Unless in corners, or displaced since it's non WB bone, mostly conservative
427
What structure can get injured with humerus shaft fractures?
Radial nerve
428
Ulnar nerve palsy findings?
- Claw hand
| - Unable to abduct fingers
429
Radial nerve palsy findings?
Unable to extend wrist
430
Median nerve palsy findings?
Unable to make OK sign (finger opposition)
431
Simple forearm fracture Mx (1)
Above elbow cast (to avoid supination/pronation)
| Always do 1 joint below and above
432
Simple Wrist fracture Mx (1)
Below elbow cast
433
Olecranon fracture Mx (1)
ORIF (intrarticular normally)
434
Pulled elbow Ix (1)
None
435
Pulled elbow Mx (1)
Passive pronation and flex elbow
436
Maxillary # Mx (1)
Send to maxfax as can affect teeth modelling
437
Nasal # Mx?
```
Non-displaced = conservative
Displaced = Max-fax referral
```
438
Orbital # Mx?
Send to ED urgently
439
Facial fracture ED referral indications? (3)
Pain with eye movements
Diplopia
Depressed malar eminence
Hyphaema
440
Pelvic # Mx
Usually conservative if non-displaced
441
Patellar # signs
Unable to straighten (extend) knee or SLR
| as pulls on quads tendon
442
Patellar # Mx
No displacement = Immobilise walking plaster cylinder 4 weeks
Displacement or unable to extend knee = K wires
443
Distal fibular # Mx
POP back slab/moon boot
444
Repetitive back rotational movements leading to pain. Dx?
Spondylosis
445
Spondylosis Mx (1)
Rest from aggravating activity for 6 weeks
446
Radius/Ulnar # Mx
- If both fractured and aligned = heals well with cast
- Rotational deformities = reduction
- Displaced = operation
447
Colles # Mx
- Non-displaced = below elbow cast 4 weeks
| - Displaced = reduction
448
Scaphoid # Mx
- Displaced = ortho referral
| - Non-displaced = thumb spica cast
449
Mallet finger Mx
- Simple = Full extension splint
| - Fracture/complex = surgery
450
Subscapularis action
Internal rotation
451
Teres minor action
External rotation
452
Infraspinatus action
External rotation
453
SLE Ix (3)
ANA +ve
anti-dsDNA
anti smith antibodies
454
RA Ix (3)
RF +ve
anti CCP
ANA +ve
455
Scleroderma Ix (1)
Limited anti centromere
Systemic anti SCL 70
"anti topoisomerase 1
456
Cut off for normal endometrial thickness post-menopause
<4mm
457
During what time of menstrual cycle is it best to get a TV US done to Ix?
Day 5-10 of menstrual cycle
458
Normal endometrial thickness PRE-menopausal
<12mm
459
Normal endometrial thickness PERI-menopausal
<5mm
460
What medication to give to stop breastmilk production
Cabergoline 1mg stat dose
461
COCP given and patient develops migraine with aura
Stop COCP
462
COCP Smoker >35 but quit last year
Stop COCP
463
COCP FHx of breast cancer <30yo
Okay to take COCP. Only PHx of breast ca
464
Major surgery with immobilisation, okay for COCP
No. high risk VTE
465
Sudden onset neck pain with RA/Down's syndrome
Atlanto-axial disruption
466
Examination findings for cervical radiculopathy
Spurling test, slightly lateral flexion neck and push down head causes pain
467
Middle finger nerve root distribution
C7
468
Shoulder pain + stifness in all directions, active and passive movement pain
Frozen shoulder
469
Shoulder pain, active movements only, external rotation, abduction
Rotator cuff injury
470
Shoulder pain with Passive overhead movements
Bursitis/Impingement
471
Repetitive throwing -> shoulder pain
Glenoid Labrum Tear
472
How to assess for AC joint disruption
Paxinos sign - pinching AC joint together
| Passive adduction of shoulder
473
When to consider radicular back pain imaging?
>6 weeks, trial physical therapy
474
Ankylosing spondylitis triad
<40yo
Lasting >3 months
Morning stifness improving with exercise
475
Repetitive rotation causing back pain
SpondyloLYsis
476
Teenager with kyphosis, can't touch toes
Scheuermann's disease
477
Risk Factors for Carpal Tunnel Syndrome (4)
- Diabetes
- Hypothyroidism
- Pregnancy
- Trauma
478
When to give ABX for rhinosinusitis? 3 criteria
Fever > 38
Discoloured purulent discharge
Severe localised pain
479
Pain on lateral thigh, worse on pressure and climbing stairs
Greater Trochanteric Pain Syndrome (including bursitis)
480
Young athlete, tenderness in pubic symphysis
Osteitis Pubis
481
Young person who jumps a lot, pain inferior knee cap
Patellar Tendinopathy
482
Female and obesity, anterior knee pain ,worse with sitting prolonged period of time (movie theatre sign)
Patellofemoral Pain Sydrome
483
Teenager with pain on tibial tuberosity
Osgood Schlatter Disease
484
Painful knee clicking
Meniscal tear
485
Suprapatellar pain after overuse, worse at night
Quadriceps Tendonitis
486
Marathon runner with lateral pain on thigh
Iliotibial Pain syndrome
487
Pain in knees after kneeling prolonged period
Prepatellar bursitis
488
MRI knee rebatable conditions (2)
16-49 yo with either
- Acute ACL concern (following trauma)
- Acute unable to straighten knee (meniscal tear)
489
Unfit tennis player with calf pain during lunge
Gastrocnemius tear
490
Spa folliculitis. Causative organism + ABx choice?
Pseudomonas Aeruginosa
| Ciprofloxacin
491
Shaving folliculitis causative organism + Rx
Staph aureus
| Mupirocin 2% ointment bd
492
RF for scabies (3)
Nursing homes
ATSI
HIV
493
Onycholysis Rx (2)
Keep nails short
Avoid exposure to contact irritants
Wait for nail to regrow (separated nail won't reattach)
494
Dermatoscopy - thrombosed capillaries
Warts
495
Plane (flat) warts on face treatment
tretinoin 0.05% cream daily for 3 months
496
RF for DDH (3)
Female
Breech
FHx
497
When to do US for DDH
6 weeks - 6 months, after this XR is better
498
Organic causes of constipation in children (3)
Allergy
Coeliac Disease
Hypothyroidism
Hypercalcaemia
499
Examination components for child constipation (2)
Abdominal palpation for faecal matter
| Inspect anus for fissures/patency
500
Hyperpigmentation, weight loss
Addison's
501
How is sarcoidosis diagnosed?
Bronchoscopy with endobrachial biopsy
502
Post exposure - when can people get chickenpox vaccine
Within 3-5 days of exposure
503
Cardiac complication of Marfan's syndrome?
Aortic dissection
504
Marfan's syndrome inheritance pattern?
Autosomal dominant
505
What valvular problem is in Marfan's?
Mitral valve prolapse (MVP = tall guy)
506
Wernicke's Encephalopathy triad
- Confusion/Encephalopathy
- Ataxia
- Occulomotor dysfunction
507
Wernicke's treatment
IV thiamine 300mg tds -> 100mg IV daily -> oral 100mg thiamine (severe thiamine deficiency)
508
Korsakoff syndrome features?
Memory loss from chronic B1(thiamine) deficiency
509
Poor prognosis indicators in RA (3)
> 20 joints affected
High sustained ESR
Smoking
Impaired function early in disease
510
How long is erythema infectiousum contagious for
Until 24 hours after fever settles
511
Neonatal cephalic pustulosis Rx
Ketaconazole 2% topical bd
512
Fibromyalgia 1st line Rx
Amyitryptyline 10mg oral
513
What medications interact with COCP (2)
- Anti-epileptics
| - Rifampicin
514
What contraception to use with anti-epileptics (2)
Mirena IUD
| Medroxyprogesterone 150mg every 12 weeks
515
3 reasons for referral for acne
- Severe
- Considerable scarring
- Emotional/Social impact
516
Pre-eclampsia + Gestational Hypertension gestation diagnosis
>20 weeks
517
Cardioselective beta-blockers (4)
Atenolol
Bisoprolol
Nebivolol
Metoprolol succinate
518
Causes of mouth breathing in children (3)
Allergic rhinitis
Deviated nasal septum
Adenoid hypertrophy
519
Smooth philtrum in child
Foetal Alcohol Syndrome
520
What blds to order when suspecting ADHD to exclude organic cause? (3)
- FBE
- iron studies
- TFT's
521
Boxer # findings and Rx
Angulation of 5th metatarsal, K-Wire insertion
522
Morton's neuroma location
Typically 3rd and 4th MTP joint space
523
Morton's neuroma Rx (3)
Loose shoes with sponge metatarsal pad/Conservative (30% involute)
CSC injection
Surgical
524
Tibialis Anterior tendinopathy findings
Pain on plantar flexion (stretch) or resisted dorsiflexion (contraction)
525
5th metatarsal fracture Mx
If undisplaced, NWB for 4 weeks
| If displaced or Jones (avulsion) #, ortho referral
526
Calcaneal # Mx
```
Caused by severe axial loading force
Ortho referral (urgent)
```
527
Ankle Ottawa rules
Malleolar or Midfoot pain with either
Tenderness on these sites or inability to WB
528
Ankle tendinopathy history
Pain on rising after sitting
529
Plantar fasciitis history
Pain early morning during first steps
530
Tarsal Tunnel Tinnel test location
Inferior to medial malleolus
531
Tarsal tunnel syndrome Mx (2)
Orthotics
ICS injection
Surgical release
532
Elderly patient with medial foot/ankle pain and flat feet
Posterior tibialis tendinopathy
533
Posterior tibialis tendinopathy sign
Pain on resisted ankle inversion during plantar flexion
534
Ballet dancer, big toe pain on flexion
flexor hallucis longus tendinopathy
535
Name of test to check fo achilles tendon rupture?
Simmonds test (kneel on chair and calf squeeze)
536
Painful tiny fat lobules on heel. Dx?
Piezogenic Papules
537
Piezogenic Papules Mx?
Weight loss or cushioning
538
Active child with night time ankle pain
Tarsal coalition (accessory tarsal bone)
539
Severs disease age + pain location (Calcaneal apophysitis)
7-15yo - heel pain
540
Severs disease Mx (2)
Raised heel shoes
| Avoid strenuous sport for 12 weeks
541
Paget's disease Ix
Bone specific alkaline phosphate antigen
542
Sunburst appearance on XR
Osteosarcoma
543
Onion skin on XR
Ewing sarcoma
544
Pseudogout Ix
- Synovial joint aspiration with calcium pyrophosphate crystals
545
Dupuytren's contracture difference with trigger finger
Dupuytren's cannot be reversed
546
Dupuytren's contracture associations
○ Overuse
○ ETOH
○ T2DM
Liver disease
547
Dupuytren's Ix (2)
○ FBGL
| LFT's
548
Dupuytren's Mx (3)
- Watchful waiting
- Physio/Hand therapy
- Collagenase injections
- Consider plastics/ortho referral
549
Rheumatoid extra-articular manifestations (3)
Episcleritis, carpal tunnel syndrome, pericarditis
550
Reactive arthritis extra-articular manifestations (2)
Urethritis, conjuncitivitis
551
Gout Mx (2)
Maintain healthy weight
| Abstain from triggers (ETOH, red meat, soft drink)
552
Gout flare prophylaxis Rx
- NSAID - naproxen 500mg bd
OR
- colchicine 0.5mg daily or bd
553
Gout prevention Rx
Allopurinol 50mg daily for 4 weeks, titrate with uric acid
554
Urate targets
<0.36 for gout
| <0.3 for gouty tophi
555
Nailbed injury Ex (2)
- Check neurovascular status
| - Check signs of fracture by finger movements (needs XR if suspicious)
556
Pseudogout Mx
Same as gout except for NSAID use
557
Osteomyelitis Rx (1)
IV flucloxacillin QID
558
Paget's disease XR findings (3)
- Cortical thickening
- Sclerosis
Trabeculations of bone
559
Examination finding for plantar fasciitis (1)
- Pain on dorsiflexion of big toe (stretches plantar fascia)
560
PMR referral indications
○ diagnostic uncertainty
| patient < 50yo
561
PMR Mx (2)
- Prednisolone – 15 mg/day for 1 month, then wean.
| - Low-impact, light aerobic exercise to mitigate the effects of steroids
562
Definitive way to diagnose Rickets
XR
563
Morphea linked with?
Scleroderma
564
Myasthenia Gravis Ix (1)
Acetylcholine receptor antibodies
565
Motor Neurone Disease presentation
Hyperreflexia in wasted limb
566
Receptive aphasia, brain lobe?
Temporal
567
Expressive apahsia, brain lobe?
Frontal
568
Spatial disorientation, mathematics, brain lobe?
Parietal
569
Recognising faces/objects, brain lobe?
Temporal
570
Sparing of forehead with facial weakness?
Stroke
571
Bell's Palsy Rx (3)
Prednisolone 1mg/kg (up to 75mg) daily for 5 days
Lubricating eye drops/Tape eye when not being used
Facial massage
Takes 3 months to recover
572
Ramsay Hunt Syndrome Rx (1)
- Valaciclovir 1g tds for 7 days
573
Carpal Tunnel Syndrome associated conditions? (4)
T2DM
Pregnancy
Repeated movements
RA
574
Carpal Tunnel Syndrome Mx (4)
- Night time splint
- Avoid repeated/overuse
- Referral to physiotherapist
Ultrasound guided corticosteroid injection at wrist
575
Medication for prevention of cluster headache? (1)
Verapamil
576
Huntington's Disease inheritance pattern?
Autosomal dominant
577
Symptoms of intracranial hypertension (2)
Severe headache
| Blurred vision
578
Migraine Rx (3)
Sumatriptan 50mg oral, then 2 hours later if needed
Ibuprofen 400mg tds
Metoclopramide 10mg tds
579
Migraine prophylaxis Rx (1)
Amitryptylline 10mg daily
580
Myasthenia Gravis presentation
NIL SENSORY, muscle weakness, diplopia and ptosis
581
Parkinson's triad
Cog-wheeling rigidity
Shuffling gate
Pill rolling tremor
582
What two anti-emetics to avoid in Parkinson's?
metoclopramide
| prochloperazine (stemetil)
583
When to avoid levodopa
Addiction/Gambling problems
584
Perioral dermatitis mild (1)
metronidazole 0.75% cream or gel topically, twice daily for 4 to 6 weeks until skin returns to normal
585
Perioral dermatitis moderate Rx (1)
Doxy 100mg daily
586
Diabetic neuropathy Rx (1)
amitriptyline 5mg nocte
587
Restless legs Syndrome Rx (3)
Gabapentin 100mg/Pregabalin 25mg
Pramiprexole 0.125mg daily
Levodopa benzaride 100/25mg
588
When are seizures resolved?
- Resolved if seizure free for 10 years (including 5 medication free)
589
Post-ictal definition
>10 minutes of
- Disorientation
- Memory loss
- Decreased verbal/interactive skills
590
Simple seizure meaning
no impaired awareness
591
Complex seizure meaning
impaired awareness
592
Occipital partial seizure symptoms
contralateral vision aura
593
Parietal partial seizure symptoms
contralateral sensory neuropathy
594
Temporal partial seizure symptoms
psychic changes (jamais vu, déjà vu)
595
Epilepsy diagnosis?
2 seizures at least 24 hours apart
596
Shingles Ix (1)
○ Viral swab for PCR
597
When to give Zoster vaccine after shingles diagnosis?
12 months afterwards
598
Shingles lifestyle advice (2)
Avoid contact with children, pregnant women and immunosuppressed until crusted lesions
Cover rash with non-stick dressing and Vaseline
599
Shingles Rx (2)
Valaciclovir 1g tds 7 days
Lidocaine 5% patch
Gabapentin 100mg/Pregabalin 25mg
600
Post stroke Rx (3)
- ACEi (aim for SBP 120-130)
- Atorvastatin 80mg daily
- Aspirin 300mg first day, then 100mg daily
601
Essential tremor Rx (1)
Propanolol 10mg bd
602
Trigeminal Neuralgia Mx (2)
1. Avoid touching face
| 2. Carbamazepine MR 100mg bd
603
Wernicke's Encephalopathy triad
- Ophthalmoplegia (Diplopia)
- Ataxia
- Confusion
604
Wernicke's Encephalopathy Rx (1)
Thiamine 300mg IV for 3 days, then 100mg daily oral
605
Private Licence acuity requirements
At least one eye 6/12
606
Commercial Licence acuity requirements
Better eye at least 6/9 AND
| Worse eye at least 6/18
607
Skin conditions linked with blepharitis (3)
Acne
Rosacea
Seborrhoeic Dermatitis
608
Blepharitis Non-pharm Mx (3)
- Warm compresses daily for 2 to soften crusts
- Gentle scrubbing of lashes with
- Massage eyelid
Sodium bicarbonate
609
Anterior blepharitis Pharm Mx (1)
If symptoms not controlled - chloramphenicol 1% eye ointment BD for 2 weeks
610
Amaurosis Fugax Mx (1)
- Referral to a neurologist within 72hrs of symptoms
| Stop driving for 4 weeks
611
Cataracts RF (4)
- Smoking
- Age
- T2DM
Excessive ETOH consumption
612
Complete Heart Block Rx (2)
Atropine 0.5mg IV stat
| Pacemaker
613
SVT Rx (1)
Adenosine IV 6mg
| after trying Valsalva
614
SVT prophylaxis
Atenolol 25mg oral
615
V tach if stable Rx (1)
Amiodarone
| If unstable, needs DC shock
616
Which NSAID's have lowest GI SE's
COX-2 inhibitors - Celebrex/Celecoxib
617
When to do 6 monthly AFP and Liver us for HCC surveillance? (2)
Cirrhosis and Chronic Hep B
618
Alcohol related liver disease specific findings (3)
Dupuytren's contracture
Proximal myopathy
Parotidomegaly
619
Acute MiILD ascites Rx (2)
Spironolactone
Frusemide (second line)
Sodium restriction
620
Hepatic encephalopathy signs
Asterixis
Confusion
Muscle rigidity
621
Genital herpes Mx (3)
Valaciclovir 500mg bd for 10 days
Lignocaine gel topically to lesions/paracetamol 1g QID
Urinate in bath/shower if dysuria
622
Genital warts Mx options (4)
- No need for treatment if not causing discomfort
- Cryotherapy
- Imiquimod 5% cream, alternate days until warts resolve
OR
- Podophyllotoxin 0.5% paint, bd for 3 days followed by a 4-day break; repeat weekly until warts resolve.
623
Opioid toxicity withdrawal Rx (1)
IV naloxone
624
Baby well in between episodes of vomiting with distress and pallor?
Intussusception
625
Intussusception age
2 months to 2 years
626
ETOH abstinence Rx (3)
Acamprosate - 666mg TDS
Disulfiram (Antabuse) 100mg daily
Naltrexone - 50mg daily
627
Bartholin's abscess Mx (1)
Semi urgent gynae referral for marsupialisation IF recurrent
628
Patient complaint Mx (3)
Apologise to patient that "this has happened" (even if not your fault)
Offer to show clinic's policy for lodging a complaint
Discuss with medical defence organisation
Document your actions and discussion points
629
Negative birefrigerence crystals joint aspirate
Gout
630
Rhomboid shaped crystals, joint aspirate
Pseudogout
631
Positive birefrigerence crystals joint aspirate
Pseudogout
632
Needle shaped crystals, joint aspirate
Gout
633
Medication overuse headache Rx (2)
- Change to ibuprofen 400mg tds for 5 days, then 3 days/week, then stop
OR
- Prednisolone 50mg daily for 3 days, then taper over 10 days
634
Tension headache prophylaxis Rx (1)
Amitriptyline 10mg daily
635
Bacterial conjunctivitis Rx (1)
Chloramphenicol 0.5% drops 1 drop QID for 7 days
636
Viral conjunctivitis Mx (3)
Cold compresses
Lubricating eye drops
Hand hygiene
637
Allergic conjuncitivitis Rx (1)
olopatadine 0.1% 1 drop bd
638
Follicular conjunctivitis causes
Viral and chlamydia
639
Papillary conjunctivitis causes
pABillae (allergic and bacterial)
640
Chlamydial conjuncitivitis /Trachoma Rx (1)
Azithromycin 1g as single dose for all household contacts
641
Gonorrhoea conjuncitivitis Mx (2)
Urgent referral to ophthal
| Ceftriaxone 1g stat IM and 1g Azithromycin oral stat
642
Coagulopathy after bite - animal/insect?
Brown snake
643
Most deadly spider
Funnel-web
644
Acute cholangitis triad
Jaundice, Fever, RUQ Abdo pain
645
Acute cholangitis Mx (1)
Refer to ED
646
High risk patient (pregnancy) exposed to shingles Rx?
Zoster immunoglobulin
647
Anal fissure Rx (1)
Glyceryl Trinitrate 0.2% ointment tds
648
Exercise induced asthma Rx (1)
If on most exercise days - first line = ICS
| If very occasional - first line = SABA 15 mins before
649
Causes of leukocoria in children (3)
1. Retinoblastoma
2. Coat's disease (retinal vessel growth)
3. Congenital cataract
650
Dacrocystitis Rx (1)
Cefalexin
651
How to calculate ovulation date?
Length of period -14 days
652
Weakness + joint/muscle pain + violaceous facial rash
Dermatomyositis
653
Allopurinol hypersensitivity syndrome features (3)
High fever
Rash
Kidney Failure
(Life threatening)
654
What PHx to avoid probenacid in? (uric acid lowering med)
Kidney stones
655
Inflammatory picture hand joint pain DDx (5)
- RA
- SLE
- Reactive arthritis
- Psoriatic arthritis
- Scleroderma
656
Rheumatoid Arthritis Mx (3)
- NSAID's
- Fish oil daily
- Physiotherapy
- Rest from exacerbating activities
- Quit smoking
Referral to rheum/pred
657
People on MTX can develop what deficiency?
Folic acid (1mg daily)
658
Complications of PMR (3)
- Giant cell arteritis
- Stroke
- Depression
- Chronic pain
659
Paget's disease Rx
Zoledronic acid (or bisphosphonates)
660
Cryotherapy areas to avoid (3)
Head, neck, sides of fingers (nerves)
661
Which preterm/low birth weight infants need extra Hep B at 12 months?
<2000g or <32 weeks
662
TOC gonorrhoea
2 weeks for all infections other than uretheral infection
663
Gonorrhoea retest
3 months
664
Rabies exposure, vaccinated. Rx?
2 doses vaccine
665
Rabies exposure, never vaccinated. Rx?
4 doses vaccine and give HRIG
666
Small corneal abrasion Rx (1)
Chloramphenicol 0.5% eye drops, 1 drop QID daily
AND double eye pad
667
3 broad causes of dry eyes?
1. Functional (aging)
2. Systemic diseases (SLE, RA, Sjogren's syndrome)
3. Drugs (TCA, beta blockers)
668
Episcleritis Mx?
Self-resolving 2-4 weeks
| NSAID's for discomfort
669
Scleritis Mx?
Urgent ophthal review
670
Acute angle glaucoma Rx (1)
Pilocarpine 2% 1 drop
671
Fundoscopy findings for glaucoma (3)
Drusen (yellow deposits in retina)
Subretinal Haemorrhage (red patches)
Cupping
672
3 classes of medications for open angle glaucoma
1. Prostaglandins- Latanoprost (Xalatan)
2. Beta blockers -Timolol (Tenopt)
3. Alpha adrenergic agonist (AAA) - Pilocarpine
673
Gestation you can fly at?
Under 35 weeks
674
Parvovirus exposure in pregnancy management
Serology now
If non-immune, repeat in 3 weeks to check for conversion.
Will need serial US to check for foetal hydrops
675
Keratitis (NON HSV) Rx whilst waiting for ophthal review
Ciprofloxacin 0.3% eye drops every hour
676
HSV Keratitis Rx whilst waiting for ophthal review
Aciclovir 3% eye ointment 5 times daily for 14 days
677
Loss of central vision - slow
WET macular degeneration
678
Pterygium Mx (3)
- Topical lubricants
- Wear sunglasses
- If sight is affected -> surgery
679
Retinal artery occlusion presentation
- Sudden, painless loss of vision - can be central or paracentral
680
Retinal vein occlusion presentation
- Subacute distorted vision; can be transient
| Pain
681
Diabetic ophthal screening
1-2 yearly depending on glycaemic control
682
Established DM retinopathy ophthal review frequency
Reviewed by ophthal 3-6 monthly
683
Two examination tests for strabismus
Cover test
| Light reflex test
684
When is strabismus not concerning?
Intermittent and <3 months old
685
Medication treatment for temporal arteritis (3). (Must refer urgently for biopsy +/- rheum)
- aspirin 100mg daily
- IV methylpred (if evolving vision loss)
- prednisolone 50mg daily 4 weeks (no vision loss)
686
Trachoma Rx (1)
Azithromycin 1g oral stat
687
Vitreous detachment presentation
40-70yo with floaters/flashes
| Painless, blurred vision -> vision loss
688
When to refer infantile haemangiomas (3)
Ulcerated
Big
Not resolved by school age
Interference of confidence/function
689
Salmon patch/Naevus simplex Mx?
Nothing, facial ones fade within 1-2 years
690
Port Wine Stain Management?
Can refer to derm for laser if cosmetic concern.
| Persist over lifetime
691
Sturge Weber Syndrome triad?
- PWS on face
- Vascular malformation of eye (glaucoma, enlarged pupil)
- Vascular ipsilateral malformation
692
Neonatal Cephalic Pustulosis Rx(1)
Ketoconazole 2% cream, bd until clear (usually 2 or 3 days)
693
Roseola Infantum Mx?
- Once rash is present, no longer contagious
- Spares face
- Conservative management - self resolving
694
Paracetamol dose kids
15mg/kg
695
Ibuprofen dose kids
10mg/kg
696
CMPA Mx? (3)
- Mum avoid CM if breastfeeding
- Baby avoid CM
- Hydrolysed baby formula (Aptamil gold or Pepti-Junior)
- Reintroduced CM with "Milk Ladder" at 12 months age
If re-bleeds, avoid for 6 months
697
Gold standard Ix for Meckel's diverticulum?
Technetium-99 scan
698
Croup age
6 months - 6 years
699
When can you consider stopping anti-epileptics?
Seizure free for >2 years
Epilepsy resolved if seizure free for 10 years (including 5 medication free)
700
When to expect double birthweight?
6 months
701
When to expect triple birthweight?
12 months
702
Normal weight gain in 0-3 months?
150g every week or 30g per day
703
Febrile convulsions age?
6 months - 6 years old
704
Convulsions >5 mins? Rx?
Midaz (up to 10mg) buccal/intranasal
| repeat in 10 mins
705
Given baby anti-emetic and they look like they're having a seizure. Dx?
Dystonic reaction
| ondansetron is best anti-emetic
706
When to start cow's milk?
12 months (yoghurts/custards before are fine)
707
Growing pains presentation
3-5 yo and 8-11 yo
evening after intensive exercise
Thighs and calves
708
Kawasaki Disease criteria
Fever > 38.5 5 days AND "COLOR"
```
Conjunctivitis
Oral mucous changes
Lymphadenopathy
Oedema
Rash
```
709
How long to avoid live vaccines post IV methylpred/immunoglobulin
6 months after administration
710
DDH risk factors?
```
FHx
First born
Female
Funny delivery - breech
Fluid (Olighydramnios)
```
711
Imaging for DDH
Ultrasound (for 6 weeks - 6 months)
| XR (for over 6 months)
712
Intoeing age
2-4 years old
713
Bow legs age
1-3 years old
714
What age should bow legs correct by?
3
715
What age should knock knees correct by?
8
716
Normal age for thelarche in females?
8-13yo
717
Normal age for menarche in females?
10-15yo
718
Normal age for puberty in males?
9-14yo
719
Precocious (early) puberty age?
GIRLS before 8, BOYS before 9
720
Delayed puberty age?
GIRLS thelarche over 13, no menarche over 16
| BOYS over 14
721
PURPLE crying presentation
2 weeks - 5 months
| Crying 3-4 hours/day, 3-4 times/week, resolves 3-4 months
722
Neonatal undescended testicle Mx?
Watchful waiting until 3 months, after this needs surgery if not down
723
ADHD triad
>6 months
- Inattention
- Hyperactivity
- Impulsivity
724
Adjustment disorder presentation
Symptoms within 3 months of stressor, and not longer than 6 months after stressor has ceased
Out of proportion distress and impairment
725
Differentiating feature between Bipolar I and II?
No impairment of functioning with mania in II
| hypomania
726
Side effects of clozapine (2)?
- Agranulocytosis
| - Myocarditis
727
How often to review driving in dementia patient?
6 monthly
728
Dementia Rx (3)
```
Donepezil 5mg (CI seizures, heart block, asthma/COPD)
Memantine 5mg (CI seizures)
Rivastigmine
```
729
Lewy body dementia features
- Parkinsonism
| - Visual Hallucinations
730
DSM criteria for anorexia nervosa
- Fear of weight gain
- Body dysmorphia
- Calorie restriction
731
Which anti-epileptics are safe in COCP, implanon and POP?
sodium valproate, levetiracetam
732
Which contraceptive measures are safe with all anti-epileptics
Depot or IUD
733
Narcolepsy presentation
Sudden attacks of sleepiness
Hallucinations
Cataplexy (sudden loss of muscle tone)
734
Idiopathic Hypersomnia presentation
- Confusion, disorientation after waking from sleep
| - Difficult to wake from sleep
735
Lithium toxicity presentation
GI - nausea/vomiting/diarrhoea
Neuro - Tremor/hyperreflexia
CVD - QTc elongation
736
Lithium toxicity investigations (2)
Lithium levels + ECG (QTc)
737
What blds do you do for monitoring on lithium? (3)
Lithium level
TFT's (every 6 months)
eGFR (every 6 months
Calcium
738
Assessment Order criteria
- Appears mentally unwell
- Sig risk to self/others
- No less treatment that will work
739
PTSD timeframe criteria
Symptoms >4 weeks since traumatic event
740
Acute Stress Disorder timeframe criteria
Symptoms >2 days, but less than 1 month of traumatic event
741
Baby blues presentation
Less than 10 days
- Lasts for 3-5 days
- Moodiness, overwhelming feeling or anxiety
- Affects up to 80% of women
742
Psychotherapy choice for borderline psd?
DBT
743
Psychotherapy choice for eating disorders
Family Therapy for children
| CBT for adults
744
Psychotherapy choice for phobias
Desensitisation
745
Psychotherapy choice for interpersonal conflict
Insight-oriented or
| Interpersonal
746
Psychotherapy for adjustment disorder
Supportive therapy
747
How to manage hyperprolactinemia from antipsychotic?
Add aripiprazole
OR
Cease antipsychotic
748
Management of mild hypomagnesemia
500mg bd Mg tabs
749
Causes of hypermagnesemia (3)
- Excessive intake - antacids, supplements
- Kidney impairment
- Rhabdomyolysis
- Lithium
750
Medications that can cause hyperkalaemia (3)
NSAID's
Spironolactone
Trimethoprim
ACEi/ARB's
751
Management of mild hyperkalaemia
<6.5
Stop any medications contributing
Resonium A
752
Management of severe hyperkalaemia
>6.5
| Send to ED for lethal risk of arrhythmia
753
Causes of hypokalaemia?
Conn's
Insulin overdose
GI loss
Diuretics
754
Hypovolaemic Hyponatraemia causes? (3)
Vomiting
Burns
Diuretics
Adrenal insufficiency
755
Euvolaemic Hyponatraemia causes? (3)
```
SIADH
SSRI's/SNRI
Carbamazepine
Hypothyroidism
Adrenal insufficiency
```
756
Hypervolaemic Hyponatraemia causes? (3)
○ Heart failure
○ Liver cirrhosis
○ Kidney failure
- Nephritic syndrome
757
Hypernatraemia causes? (3)
Low Water
- Dehydration/Burns/Diarrhoea
- Diabetes insipidus (low vasopressin)
Sodium Overload
- Hypertonic NaCl
- Enemas
758
Hypernatraemia Management?
Slow volume replacement
759
Rash starting on neck, happens after fever subsides?
Roseola Infantum
760
Tellogen Effluvium Mx?
Reassurance, self corrects in 1 year
761
Alopecia areata Mx?
Self-resolving, can trial steroid topical/injections
762
Tinea Capitis Rx? (1)
Oral terbinafine 250mg daily 6 weeks
763
Hirsutism Rx? (1)
Cyproterone acetate
764
Seborrheic dermatitis Mx? NEONATE
Soak in baby oil for 1 hour, then wash and peel
| Can trial Salicylic acid 2% + LPC (liquor picis carbonis = coal tar solution) 2% + sulfur 2%
765
Acute paronychia Mx?
Rx = Incisision for relief (with 21G needle), nil Abx needed
766
Chronic paronychia Mx?
Rx = avoid trigger, moisturiser + strong steroid cream
767
Angular cheilitis Mx?
vaseline
768
Geographical tongue Mx?
Reassurance and antiseptic mouthwash
769
How to determine milk tongue instead of candida?
Not thick
| Present on inside of cheek as well (milk)
770
2 serology tests for post-strep GN?
Antistreptolysin O Titre (ASOT)
| Anti DNase B Ab
771
Painless small haematuria Mx?
Repeat in 6 weeks with FWT
Common causes:
- Exercise, menstruation, trauma, STI, UTI
772
Persistent haematuria Ix? (2)
Urine MCS + casts
| RBC morphology
773
AKI - pre-renal causes (2)
Hypovolaemia
- Sepsis/shock
- Burns/Trauma
- Dehydration
- Renal artery stenosis
test BP and HR
774
AKI post-renal causes (2)
RCC
BPH
test with US
775
AKI definition?
Over <48 hours
- Increase creatinine > 1.5 times baseline
OR
- Significant reduction or urine output compared to normal (0.5ml/kg/hour)
776
How much renal function reduction is okay when starting ACEi/ARB?
<25% in 2 months
777
4 common causes of CKD?
HTN, DM, PCKD and GN
778
Side effects of ACEi (2)
Cough, hyperkalaemia, angio-oedema
779
After starting ACEi, when do you repeat UEC?
2 weeks, to check for <25%
780
CKD diagnosis
> 3 months of either eGFR <60 or 2/3 elevated uACR's
781
uACR range for CKD?
Males <2.5
| Females <3.5
782
What Ix to further do once Dx with CKD? (4)
fasting lipids, glucose, ESR/CRP
| Renal tract US
783
When are statins indicated in CKD?
>50yo with any CKD
| <50yo with any CKD + stroke/DM/CVD
784
BP aim in CKD?
<130/80
785
Initially reduced eGFR, when to recheck?
7 days. if >20% reduction in eGFR, then AKI
786
When might uACR be unreliable?
- UTI/STI
- Menstruation
- Acute illness
- NSAID's
787
eGFR <60, Stage of CKD?
Stage 3
788
eGFR <30, Stage of CKD?
Stage 4
789
Overactive bladder syndrome symptoms (3)
- Urgency - key symptom
- Frequency
- Nocturia
790
Overactive bladder syndrome initial Ix (2)
- Urinalysis to exclude infection, bld or glucose
- Urinary tract US to check PVR
- Bladder diary for at least 3 days
791
When to refer renal cysts?
- Multiple cysts
- Bilateral
- Hx of malignancy
792
UTI female Rx options (3)
- Trimethoprim 300mg for 3 nights (avoid 1st trimester)
- Nitrofurantoin 100mg QID for 5 days (avoid with Ural)
- cephalexin 500mg oral bd for 5 days.
793
UTI male Rx
Trimethoprim 300mg night for 7 nights
794
UTI prophylaxis indication?
>2 UTI's every 6 months
795
UTI prophylaxis Mx (3)
1.5-2L water daily
Intravaginal oestrogen cream in postmenopausal women
trimethoprim 150 mg orally, at night
796
Non-severe pyelonephritis adult Rx
Aug DF 875/125 bd for 14 days
797
Non-severe pyelonephritis child Rx
Trimethoprim 150mg bd for 10 days
798
Oral HSV treatment
valaiclovir 1g bd
799
What blds to do before treating with terbinafine?
LFT's, risk of liver toxicity
800
What age to consider fasting lipids
>45yo
801
How often to test lipids in healthy person >45yo with previous normal results?
5 yearly
802
Within how many days worker needs to notify employer for Worksafe injury
<30 days
803
When to refer umbilical hernias neonatal?
2 years
804
When to refer neonatal inguinal hernia
<6 weeks, refer within 2 days
<6 months, refer within 2 weeks
>6 months, refer within 2 months
805
When can you tell the eye colour of baby
6 months
806
When will fontanelle close in baby
```
posterior = 1-2 months
anterior = 9-18 months
```
807
How long between breastfeeds in baby?
3 hours - to prevent lactose overload
808
When to avoid vagal manouvre
AMI
Glaucoma
Aortic stenosis
Haemodynamic instability
809
Coeliac disease testing for sensitivity
Transglutaminase-IgA (tTG-IgA),
| Deamidated gliadin peptide-IgG (DGP-IgG)
810
Coeliac disease testing for specificity
HLA DQ8, HLA DQ2 gene test
811
Chronic prostatitis Rx (1)
Ciprofloxacin 500mg bd 4 weeks
812
Acute prostatitis Rx (1)
Trimethoprim 300mg daily 14 days
813
What thyroid increases risk of OP?
Hyperthyroidism
814
When to avoid live vaccine?
>20mg CS and >14 days
| OR within 6 months of chemo/RTx
815
Lifestyle advice prior to spirometry test
- No exercise/smoking day of test
816
What age can spirometry be performed at?
6yo
817
Reversibility SABA that is significant?
12% or 200mL
818
Approach to spirometry interpretation and cutoffs?
FEV1/FVC >0.7, FVC >0.8
819
Asthma triad of physiology
- bronchospasm
- airway obstruction
- mucous production
820
RF for asthma (3)
Smoking
PMHx of atopy
FHx
?Prematurity
821
Acute asthma - MILD/MODERATE
- speaking
- HR
- O2
speaks in sentences, normal HR, O2>94%
822
Acute asthma - SEVERE
- speaking
- HR
- O2
speaks in words, accessory muscle use, tachycardia, O2 - 90-94%, distress
823
Asthma - MILD/MODERATE. PEFR?
PEFR 50-75%
824
Asthma - SEVERE. PEFR?
PEFR 33-50%
825
Asthma classification. Intermittent with frequent flare ups?
no symptoms between attacks
| attacks <1.5 months apart
826
Asthma classification. Intermittent with infrequent flare ups?
no symptoms between attacks
| attacks >1.5 months apart
827
Asthma classification. Persistent - mild?
persistent = weekly symptoms or x2 nights/month
MILD =
FEV1>80%
Daytime symptoms more than once/week
828
Asthma classification. Persistent - moderate?
persistent = weekly symptoms or x2 nights/month
MODERATE =
FEV1>61-80%
Night symptoms more than once/week
829
Asthma classification. Persistent - severe?
persistent = weekly symptoms or x2 nights/month
SEVERE =
FEV1>60%
Continuous day/night symptoms
830
Pulsus paradoxus meaning?
decreased BP and pulse amplitude during inspiration
Sign of asthma
831
Second line testing for asthma?
Challenge testing (bronchial provocation) (metacholine; muscarinic agonist measuring hyper-responsiveness of asthma)
832
Phaeochromocytoma triad
Headache, palpitations and sweating with fever
833
How many days of pred for asthma flare?
3 days (given for moderate episode or worse)
834
3 history of poor asthma/COPD control
1. Night symptoms
2. >2 days/week daytime symptoms or SABA use
3. Limitation of activity or sleep
835
When can you step down asthma inhalers?
Well controlled for 6 months
Review in 1 month
836
ICS example and dose
fluticasone propionate - 1 puff bd
Kids - 50mcg
Adults - 125mcg
837
ICS/LABA example and dose
fluticasone propionate 50mcg (children), 125mcg (adults) +
salmeterol 25mcg
1 puff bd
838
Montelukast dose
2-5 years old: 4mg daily
| >6 years old: 5mg daily
839
Symbicort age?
>12yo
840
Asthma step up after low dose ICS
Under 12, increase to high dose ICS
| Over 12, add LABA to low dose ICS
841
Gold standard for Ix bronchiectasis?
HRCT
842
Bronchiectasis exacerbation Rx?
1. Amoxicillin 1g tds for 14 days
| 2. Doxycycline 100mg bd for 14 days
843
What demographic should COPD be considered in?
>35yo + smoker/dust/gas/fumes
844
COPD CXR signs (2)
(Hyper-inflated lung fields)
- More than 6 anterior or 10 posterior ribs at mid clavicular line
- Flattened diaphragm
845
COPD exacerbations Mx steps
Worsening COPD (cough/sputum) = More SABA (4-8 puffs every 3-4 hours)
Infection (fever, sputum colour/volume) = Pred 50mg 5 days AND
Amoxicillin 500mg tds or doxy 100mg daily for 5 days
846
COPD step up approach
1. SABA or SAMA
2. Add LABA or LAMA
3. Add ICS
847
After initiating new inhaler for COPD, when to reassess?
6 weeks
848
When to repeat spirometry in COPD patients?
Every 2 years or if symptoms worsen
849
What type of inheritance pattern is cystic fibrosis?
Autosomal recessive
850
Investigation for cystic fibrosis?
Sweat test
851
Complications of cystic fibrosis? (4)
Infertility
Steatorrhoea
DM
Recurrent respiratory infections
852
Which CCB and ABx is linked with pulmonary fibrosis (2)?
Amiodarone and Nitrofurantoin
853
Granulomatous lung disease types (2)
Sarcoidosis/Hypersensitive pneumonitis
854
Which interstitial lung disease is NOT linked with smoking?
Sarcoidosis
855
Pancoast tumour triad?
Shoulder pain
C8-T2 radicular pain
Horner syndrome (ptosis, miosis, anhidrosis)
856
Common CI to home O2 supplementation?
Smoker in last 6 weeks
857
Neck size thresholds for OSA RF
Male - 43cm
| Female - 41cm
858
Two questionnaire's for OSA?
Epworth Sleepiness Scale
| Stop BANG questionnaire
859
Croup severe Rx (2)
```
nebulised adrenaline
oral dexamethasone (0.6mg/kg) OR 2mg/kg pred and 1mg/kg next day
```
860
Croup mild Rx
1mg/kg prednisolone (max 50mg) oral stat, then wait for 30 mins to check improvement
861
When to give ABx for uncomplicated diverticulitis? (3)
- Failure to improve in 72 hrs
- R) sided
- Immune compromised
862
CT shows uncomplicated diverticulitis. 4 reasons to send them anyway?
- Unable to tolerate oral intake
- Fever >39
- Sepsis
- Severe pain/peritonitis
863
What is considered high falls?
2+ falls in last 12 months
864
Falls screening questions? (3)
1. Are you presenting following a fall?
2. 2+ falls in last 12 months?
3. Are you having difficulty with balance
865
3 secondary conditions to lichen sclerosus vulvo-vaginal
Vulval cancer
Hashimoto's thyroiditis
Pernicious anaemia
Vitiligo
866
Driving reviews for OSA?
COMMERICAL - Annual review with sleep physician
867
Investigations for pertussis and time frame? (2)
Pertussis serology - 4 weeks +
| Nasopharyngeal swab - pertussis PCR - <3 weeks
868
Pertussis isolation period
5 days
869
Pertussis household contacts. Who needs acute Rx?
Treat member if in contact with childcare/<6mo/pregnancy/unimmunised
870
Pertussis household contacts. Who needs vaccination?
All close contacts who have not had booster within 10 years
871
Pertussis Rx (1)
ONLY if infection less than 3 weeks symptomatic
1. Azithromycin 5 days - 500mg 1st day, then 250mg daily for 4 days
- Child = 10mg/kg for 5 days
872
Pleural Effusion - transudative causes (3)
Heart Failure
Liver Failure
Kidney failure (nephrotic syndrome)
Hypothyroidism
873
Pleural Effusion - exudative causes (3)
Infection - pneumonia
Malignancy - Lung
Connective tissue disorder - SLE
Sarcoidosis
874
Atypical pneumonia symptoms
Dry cough, low grade fever, body aches
| Patchy bilateral infiltrates
875
Typical pneumonia Rx?
1. Amoxicillin 1g tds for 5-7 days (pneumonia = double dose of amoxi)
876
Atypical pneumonia Rx?
Doxycycline 100mg bd for 5-7 days
877
Legionella Pneumonia Rx?
Azithromycin 500mg daily for 3-7 days
878
Pneumocystis Jirovecii Rx?
1. Trimethoprim + Sulfamethoxazole 480/2400mg tds for 21 days
879
Typical pneumonia pathogens (3)
- Strep pneuominae
- Haemophillus Influenzae
- Legionella
880
Air-conditioning spreading pneumonia? Pathogen?
Legionella
881
How to diagnose Legionella pneumonia
Urine Ag or swab/sputum PCR
882
Atypical pneumonia pathogens (3)
- Mycoplasma pneumoniae
- Chlamydia pneumoniae
- TB
- Pneumocystis jirovecii
- Viral
883
Spontaneous pneumothorax acute Mx (2)
Observe for 4 hours
If hemodynamically stable, can D/C with analgesia
Normally resolves in 24-48 hours
884
Spontaneous pneumothorax monitoring (2)
2 weekly CXR's until cleared
| If not resolving by 8 weeks, refer to resp
885
Radiation pneumonitis Rx (1)
Prednisolone 40mg daily for 2 weeks then wean over 6 weeks
886
How to approach PE suspicion?
Well's score high -> CPTA
| Well's score low -> PERC rule
887
ECG findings for PE?
Deep S wave in Lead I, deep Q wave in Lead III and inverted T wave in Lead III
888
Recommendation of gap between pregnancies?
2 year gap (<12 months = complications)
889
When to take folic acid in pregnancy
1 month prior to conception, continue until end of 1st trimester
890
When to take iodine in pregnancy?
As soon as trying + through to breastfeeding
891
When to do DTP vaccine in pregnancy?
20-32 weeks, at least 3 weeks before birth
892
When to do OGTT in pregnancy?
24-28 weeks
893
When to give anti-D in pregnancy and dose?
If bleed 12+ weeks and Rh -ve,
650IU anti-D injection within 72 hours
894
Under 35yo with breast changes. Ix?
Ultrasound +/- mammography
895
Over 35yo with breast changes. Ix?
Ultrasound + mammography (unless pregnancy/lactating, only for suss results or high clinical suspicion)
896
Suspicious breast change. Ix?
Ultrasound + mammography AND refer to breast surgeon regardless of result
897
When to refer fibroadenoma to surgeon? (2)
> 3 cm or persistent pain
898
Normal risk breast ca screening
50-74
Repeat every 2 years
If FHx, every 1-2 years
899
Physiological nipple discharge features (3)
1. Bilateral
2. Milky/yellow
3. On expressing
900
PERC rule positive
1. Oestrogen use
901
Breast thrush Mx (non Rx) (3)
- Sterilise dummy every day
- Keep nipple dry
- Wash hands frequently
902
Galactocele Mx
- If asymptomatic + not infected, Reassure.
| Aspiration if persisting after breast feeding has ceased
903
Insufficient breast milk supply signs? (2)
1. Baby demanding frequent feeds: continually suck hand
2. Less than 3 wet nappies/24 hours
3. Weight gain should be ~25g per day or a minimum of 150g per week
904
Insufficient breast milk Mx (3)
Breastfeed frequently
Offer each breast twice
Express after feeds
905
Insufficient breast milk 2 Rx options
1. Domperidone 10mg tds
| 2. Metoclopramide 10mg tds
906
Mastitis Rx
1. Flucloxacillin 500mg QID for 5-10 days
Allergy: cephalexin 500mg QID 5-10 days
907
Suppression of lactation Rx (1)
Cabergoline 1mg stat dose
908
Post-menopausal bleeding Ix (3)
1. TV US including endometrial thickness (<4mm = normal)
2. Co-test
3. STI screen
909
Who needs chickenpox Rx?
Adults, children <28 days, eczema, immunocompromised
910
Primary amenorrhoea definitions (3)
1. Not had menarche by 15yo
2. Not had menarche and >3yrs post thelarche
3. Not had menarche by 13yo with no sexual development
911
Secondary amenorrhoea definition
no menstruation for 3 months (regular) 6 months (irregular) in a woman previously menstruating
912
Missed pill and less than 7 active pills taken?
Usual advice and
| Consider emergency contraception if it has occurred in last 5 days
913
Missed pill and less than 7 active pills left?
Skip inactive pills and go straight to active pills in next pack
914
3 Emergency contraceptions, dose and time frame
1. Levonorgestrel 1.5mg <3days
2. Ulipristal acetate 30mg <5 days
3. Copper IUD <5 days
915
UPA (emergency contraception) special considerations (breastfeeding and COCP)?
Wait 5 days before COCP start
| Express and discard milk for 1 week
916
SE of emergency contraception (3)
Nausea
Breast tenderness
Spotting
917
Increased risks of COCP (4)
VTE
Stroke/MI
Gall bladder disease
Cervical cancer
918
2 ways of starting COCP
1. Active pills on 1st day of period (no contraception needed)
2. Quick start, condom 7 days, pregnancy test in 4 weeks
919
NuvaRing action
- Insert ring and keep in for 3 weeks then remove for withdrawal bleed
920
Contraindications to POP (1)
Breast cancer in last 5 years
921
How quick does POP start to work?
2 days, if missed pill, need condoms for 2 days as well
922
Window for POP?
3 hours
923
How long does implanon take to work?
7 days
924
2 ways of starting Implanon
1. Inserted 1st day of period (no contraception needed)
| 2. Quick start, condom 7 days, pregnancy test now and in 4 weeks
925
Implanon duration of effectiveness?
3 years
926
Depot Provera generic name
Medroxyprogesterone acetate
927
Depot Provera window of dosing
12 weeks (>14 weeks is delayed)
928
How long is delay in fertility of depot provera?
Up to 1 year
929
Apart from pregnancy, what condition to check before Mirena insertion?
Chlamydia screen
930
When to insert IUD?
1-5 days of period
931
When to review IUD after insertion
4 weeks for position and repeat pregnancy
932
When to use endocervical brush as well as cervical sampler? (2)
Non-visible transformation zone (post-menopause or post LLETZ)
933
Cervical ca screening routine age and frequency
25-74yo 5 yearly
Immunodeficiency = 3 yearly
934
Early sex <14yo before HPV vaccination, when to test CST?
Single HPV test between 20-24yo, then routine
935
If inadequate sample on HPV test?
Recollect in 6-12 weeks
936
When do you only need 2 abnormal HPV results before referral for colposcopy? (3)
○ Only 2 strikes if:
□ 50+yo
□ ATSI
- Overdue for screening by 2+ years
937
After colposcopy/high risk patient, when can they return to normal screening?
- TWO normal co-tests before they can go back to normal screening
938
Who is eligible for self collection CST? (2)
30yo + either
>2 years since last test or never been tested
939
Immune deficient + HPV detected, but not 16/18. Mx?
Colposcopy (any HPV in immune-deficient = colp)
940
Hysterectomy CST screening?
1. None if benign condition
2. 2x annual co-test until 2 negative results
3. Subtotal (cervix still present) - routine
941
Pain on sexual entry, young female?
Vaginismus (pelvic floor spasm)
942
Pain on sexual entry, burning on light touch
Vulvodynia
943
When to do early OGTT for high risk pt?
16 weeks
944
Postpartum GDM monitoring? (2)
OGTT 12 weeks post delivery
| FBGL + HbA1c 3 yearly thereafter
945
Glycaemic targets for GDM?
| Fasting, 1 hour post, 2 hours post
- FBGL <5
- 1 hour after meals <7.4
2 hours after meals <6.7
946
Subfertility definition?
>12 months if <35yo
| >6 months if >35yo
947
Sub-fertility lifestyle advice (3)
1. Smoking cessation
2. Weight loss 5-10% if BMI >30
3. Ovulation awareness + intercourse at least 3 times/week
948
Premature menopause age?
<40yo
949
What age can you use COCP/vaginal ring until with menopause?
50yo
950
When has someone hit menopause?
>12 months from LMP (but 2 years if <50yo)
951
How long is contraception needed in menopause
12 months after final period for >50yo
| 24 months after final period for <50yo
952
How to Dx premature menopause? (2)
1. FSH >25IU on two occasions at least 1 month apart
AND
2. Amenorrhoea 6 months
953
HRT risk reductions (3)
1. Osteoporosis risk reduction
2. Colorectal cancer risk reduction
3. Diabetes risk reduction
954
Tibolone indication
Menopause only
955
Tibolone risk difference to combined HRT?
No VTE risk with tibolone
956
Atrophic vaginitis Rx (1)
Estriol 1mg/g cream - one applicatorful intravaginally nocte for 2 weeks, then reduce to t
957
SNRI name and dose for menopause?
Venlafaxine 37.5mg daily
958
What size fibroids do we refer for?
3+cm
959
What percentage of pregnancies miscarry?
15%
960
CAP children If penicillin hypersensitivity or not improving after 48 hrs?
Azithromycin 10mg/kg or clarithro or doxy
| cefuroxime for non-severe
961
If immediate penicillin allergy, what do you want to avoid?
anything ending in cilin, OR anything starting with cef (cephalosporins)
962
If mild penicillin allergy - e.g rash, what do you give usually?
Cephalosporins (cef---)
963
Osgood Schlatter Mx (1)
Quadriceps strengthening + modified activities
964
Timing between COVID vaccine and influenza vaccine?
7 days
965
What age to consider LABA addition to ICS (instead of high dose)
6yo+
966
Neonatal hydrocele, when to refer?
12 months if not resolved
967
What to do if one parent doesn't want vaccination?
Do not give, need to discuss with both parents
968
What temp to not give vaccine?
>38.5
969
Dose of anti D to give to women >10 weeks
250IU
970
What size miscarriage POC needs surgical Mx?
>5cm
971
Follow up for expectant miscarriage Mx? (2)
TV US after TWO week
| HCG every second day -> weekly
972
Follow up for medical miscarriage Mx? (2)
TV US after ONE week
| HCG every second day -> weekly
973
When is expectant miscarriage Mx considered failed
3 weeks
974
How long to try again for pregnancy after miscarriage?
2 months/cycles
975
PCOS Dx?
2 of 3
1. Irregular cycles
2. Clinical/serological hyperandrogenism
3. >12 cysts
976
What sign on FWT indicates contamination?
Epithelial cells
977
UTI Rx children (1)
Trimethoprim-sulfmethoxole 4+20mg/kg (160/800 max) bd for 3 days
978
What do if pregnancy exposed to VZV?
If had VZV, nil concern.
| If unsure, check serology before giving varicella immunoglobulin
979
What classifies as Sig exposure to VZV? (2)
Face to face for more than 5 mins
| Same household
980
When is chickenpox infectious
2 days before rash comes until crusted
981
What is the name of dislocated radius and fractured ulnar?
Monteggia fracture-dislocation
Rx = reduction
Nerve injury = radial nerve
982
What is a buckle fracture?
Incomplete fracture -> bulging or cortex but no radiolucency
983
Buckle fracture of distal radius Mx?
Below elbow removeable backslab/splint 3 weeks (buckle heals well because incomplete fracture)
984
Complete fracture of distal radius Mx?
Below elbow cast for 6 weeks + fracture clinic in 7 days
| because it is unstable and can move
985
How long limping child do you get worried and XR?
>7 days
986
When can boys retract foreskin?
17yo
987
How long is pertussis infectious (if not treated?
3 weeks
988
How long is pertussis infectious (if treated)
5 days (same duration as ABx)
989
What is classified as sig exposure to pertussis
within 1m for 1 hour
990
Otherwise intelligent and well child with generalised clumsiness?
Dyspraxia/Apraxia or Developmental coordination delay
991
Dyslexia meaning?
Poor reading and spelling
992
Diagnostic criteria for ITP?
Isolated low platelets
993
HSP triad?
arthralgia, rash and abdo pain
994
HSP investigations?
Urinalysis - protein, otherwise clinical diagnosis. Normal bleeding time, platelets and coags
995
Night terror characteriristics
Glassy open eyes, unable to recognise/be comforted
996
PID Rx
Ceftriaxone 500mg + metronidazole 400mg bd + doxy 100mg bd 14 days (double chlamydia duration)
997
When to resume intercourse post birth?
1.5 months after NVB, 3 months if tear/c-section
998
Endometritis Rx?
```
Localised = Augmentin DF bd for 7 days
Systemic = urgent ED for IV ABx
```
999
Pre-eclampsia Dx?
>20 weeks gestation
HTN + proteinuria OR HTN with end-organ dysfunctio
1000
Pre-eclampsia Mx?
Urgent hospital transfer
1001
Gestational HTN Dx?
>20 weeks, SBP >140/90 without signs of pre-eclampsia
1002
Rx for HTN in pregnancy? (3)
Labetalol (CI asthma), methyldopa (avoid in depression), nifedipine
1003
Which asthma preventer is best in pregnancy
Budesonide
1004
How long to avoid pregnancy after live vaccine?
28 days
1005
Nausea/vomiting in pregnancy? Rx (1)
Pyridoxine (vitamin B6) 25mg PO tds 1st line
1006
GORD Rx options in pregnancy? (2)
1. Mylanta PRN
| 2nd line - H2 receptor antagonist - ranitidine/famotidine
1007
Implantation bleeding timeframe?
First 2 weeks
1008
Medical termination time frame?
9 weeks
1009
Surgical termination time frame?
24 weeks
1010
Two medications for medical termination?
Mifepristone and misoprostol
1011
Vaginal candidiasis Rx?
Clotrimazole 1% PV nocte for 6 nights
1012
Tinea Cruris Rx?
terbinafine 1% top BD for 7-14 days
1013
How to diagnose lichen sclerosus vulvovaginal?
Punch biopsy
1014
Lichen sclerosus Mx? (3)
Refer to gynae
Strong steroid (diprosone OV) for 6 months - derm
Follow up every 6 months for vulval cancer checking
1015
Lichen planus difference to lichen scelrosus - vulvovaginal?
Planus = pain, sclerosus = itch
1016
Bacterial vaginosis Rx?
metronidazole 400mg BD for 7 days
1017
Urethral caruncle Rx?
Topical oestrogen
1018
Head lice Rx?
1% permethrin cream scalp. Leave for 10 mins and then repeat next week
Or maldison topically
WET COMBING
1019
Private license driving requirements?
At least one eye 6/12
1020
Commercial license driving requirements?
Better eye at least 6/9
| Worse eye at least 6/18
1021
Chickenpox Rx - children and indication
Children with immunocompromise/eczema or <28 days
| - aciclovir 20 mg/kg up to 800 mg orally, 5 times daily for 7 days
1022
Champix - how to start?
Start 1/52 before quit date
OR
Continue smoking, but stop smoking after day 8 of champix
1023
Plantar fasciitis Mx? (3)
Get arch supported shoes
Exercise to stretch calf muscle
Ice
1024
Posterior blepharitis Mx?
Systemic antibiotics used (particularly if associated with rosacea) Doxycycline 100mg daily
1025
When is denosumab dose delayed?
>4 weeks
1026
Cluster headache Rx (1)
Verapamil
1027
Elevated, firm, growing skin lesion. Dx?
Nodular melanoma
1028
Diameter cut off for melanoma concern?
6mm
1029
Tender and ulcerated new skin lesion
SCC
1030
Painful central vision loss in one eye?
Optic neuritis
1031
lower EYELID non-healing growth?
BCC
1032
lower LIP non-healing growth?
SCC
1033
Yellow spot on sclera?
Pinguecula
1034
Which side does pterygium affect?
Medial canthus only
1035
Difference between scleritis and anterior uveitis?
Scleritis = nil vision change
1036
HSV keratitis Mx (2)
Urgent ophthal review + start aciclovir 3% drops 5 times day for 2 weeks
1037
standard dose PPI
Esomeprazole 20mg or pantoprazole 40mg
1038
Photokeratitis Rx? (2)
AKA flash burn
Oral analgesia
chloramphenicol drops
1039
3 NON-idiopathic causes if subconjunctival haemorrhage?
- HTN
- DM
- Coagulopathy/Trauma
1040
Sudden onset painless loss of vision, flashes and floaters. Curtain closing over
Retinal detachment
1041
Night blindness in child?
Retinitis pigmentosa
1042
Sixth cranial nerve?
Abducens
1043
Anterior uveitis Mx
Urgent referral 24 hours to ophthal
1044
Viral keratitis Mx
Urgent referral 24 hours to ophthal
1045
What condition is linked with marginal keratitis?
Rosacea
1046
Marginal keratitis Mx (3)
Treatment is same as blepharitis (3)
- Lid massage
- Warm compress
- Scrub any crusting off
1047
Bacterial keratitis Rx? (1)
Ciprofloxacin 0.3% eye drops
1048
Herpes Zoster Ophthalmicus Rx?
Valaciclovir 1g tds for 7 days
1049
Infected tear duct Dx?
Dacrocystitis
1050
Dacrocystitis Mx (3)
Treatment is same as blepharitis (3)
- Lid massage
- Warm compress
- Scrub any crusting off
1051
Gonococcal conjunctivitis Rx? (1)
Ceftriaxone 1g IM stat and Azithro 1g oral stat
1052
Periorbital cellulitis Mx? (2)
- Flucloxacillin 500mg QID for 7 days
| - Review in 48 hrs, if not improving, IV therapy needed
1053
How to tell if raised ALP is due to bone?
Normal GGT
1054
Investigations to assess overal liver function? (2)
```
Serum albumin (raised = chronic cause)
INR
```
1055
Alcholic liver disease classic finding`
AST:ALT >2
1056
Multiple melanoma looking spots, all looking similar. dx?
Atypical naevus
1057
Behcet's disease triad
Mouth ulcer, genital ulcer, eye problems
1058
Angular stomatitis Rx?
vaseline OR (fungal) clotrimazole cream 1% bd for 2 weeks
1059
Joint pain, hearing loss, headache
Paget's disease
1060
Serology for Paget's Disease (1)
ALP
1061
Rx for Paget's Disease (1)
Bisphosphonates
1062
Eczema herpeticum Rx? (1)
Antiviral
1063
Herpetic whitlow Rx (1)
Antivirals
1064
Dermatitis Herpetiformis Rx (1)
Dapsone oral (specialists) and avoid gluten
1065
Dermatitis Herpetiformis Ix (1)
Punch biopsy
1066
Dermatitis Herpetiformis distribution (4)
Back, knees, bum, elbows
1067
What to screen 1st degree relatives of haemochromatosis with?
HFE gene mutation and iron studies
1068
Haemachromatosis genotypes? (2)
C282Y and H63D
Kids need testing =
Homozygous C282Y OR
Heterozygous combined C282Y/H63D
1069
Scalp seborrhoeic dermatitis Rx? (2) ADULT
Selenium sulphide/anti-fungal shampoo + strong steroid
1070
Body seborrhoeic dermatitis Rx? (2) ADULT
Hydrocortisone 1% + clotrimazole 1% daily until skin clear
1071
Flushing Rx (1)
1. propanolol 10mg bd
| 2. clonidine
1072
Erysipelas Rx
phenoxymethylpenicillin 500mg QID for 5 days
1073
What condition is linked with multiple granuloma annulare?
T2DM
1074
PTSD, acute stress disorder classic features
Intrusive/negative thoughts of previous trauma that causes avoidance of stimuli
1075
Adjustment disorder Mx? (2)
1. Psychoeducation, relaxation, stress Mx
| 2. Clonazepam, Diazepam, Lorazepam
1076
What herbal Rx with SSRI -> serotonin syndrome?
St John's Wort
1077
Chronic Fatigue Syndrome Timeframe?
>6 months
1078
Performance anxiety Mx (2)
1. CBT/Psychotherapy
| 2. Propanolol 10mg bd
1079
Which SSRI to avoid in pregnancy?
Paroxetine
1080
Which SSRI to avoid in breastfeeding?
Fluoxetine
1081
Excessive worry about a little medical condition?
Somatic symptom disorder
1082
What two antipsychotics can cause inc prolactin and galactorrhoea?
Risperidone and paliperidone
1083
Reversing parkinsonism from antipsychotic? Rx(1)
benzatropine
1084
Neuroleptic Malignant Syndrome Rx? (1)
Bromocriptine
1085
Cannabis overdose Rx?
Relaxation +/- Benzodiazepine
1086
Methamphetamine overdose Rx?
Benzodiazepine
1087
Opioid overdose Rx?
Naloxone
1088
What type of leg ulcers are linked with smoking
Arterial
1089
Elevated ABI, leg ulcer?
Venous
1090
Decreased ABI, leg ulcer?
Arterial
1091
Hypergranulation tissue Rx?
Silver nitrate
1092
Age to consider secondary HTN?
<30yo
1093
Box jellyfish Mx? (2)
Remove tentacles using seawater
| Apply vinegar to area
1094
How to remove jellyfish tentacles? (1)
Using seawater
1095
Bluebottle jellyfish Mx?
Remove tentacles using seawater
| Hot water immersion of limb
1096
Snake Bite Mx? (2)
```
Immobilise limb
Pressure bandage
Call ambulance
Don't wash
Contact poisons hotline if in hospital
```
1097
2 deadliest snake bites?
tiger snake
| brown snake
1098
2 deadliest SPIDER bites?
Funnel web
| Red back spider (not so bad)
1099
Red back spider bite Mx? (2)
Analgesia (pain can last for 5 days)
Tetanus
DO not pressure bandage
1100
Funnel web spider bite Mx? (3)
transfer to hospital
Pressure bandage
Contact poisons hotline for antivenom direction
tetanus
1101
1st line Rx for mild dementia (alzheimer's and lewy body) (2)
1. Donepezil OR Galantamine OR rivastigmine
1102
1st line Rx for moderate dementia?
1. Memantine
1103
4 types of dementia?
Alzheimer's
Vascular
Frontotemporal
Lewy Body
1104
If bite infection and allergic to penicillin? Rx?
Metronidazole and Doxycycline
1105
Weber A ankle fracture Mx?
WBAT in walking boot
1106
Sustained erectile dysfunction terminology?
Priapism
1107
Priapism home Mx? (2)
Cold shower on area
| Gentle jog around house
1108
Priapism ED dept Mx? (3)
Intracavernous phenylephrine injection
Corporal aspiration of bld
Request urology input
1109
2 complications of priapism?
Disfigurement
| Ongoing erectile dysfunction
1110
Mx of viral acute rhinosinusitis (3)
1. Nasal cortisone spray
2. Nasal saline irrigation
3. Paracetamol 1g QID PRN
1111
Acute bacterial rhinosinusitis but penicillin allergy Rx?
Cefuroxime 500mg bd OR Doxy 100mg bd
5 days
1112
Single Ix needed to diagnose HSP?
Urinalysis - for haematuria/proteinuria
1113
Suspected menigococcal immediate Rx? (1)
2.4g benzylpenicillin IM
OR
2g ceftriazone IM
1114
Weakness, joint pain and rash around eyes/swollen? Dx?
Dermatomyositis/Polymyositis
1115
Polymyositis/Dermatomyositis Mx?
Refer to derm urgently as could be malignant cause
1116
Smelly foot in pitted keratolysis cause?
Sulfur compounds
1117
Pitted keratolysis Rx?
Topical clindamycin 1% 10 days
Caused by moisture + bacterial growth
1118
Corn Mx? (2)
Debulk using scalpel
| Salicylic acid plaster
1119
Difference between corn and wart in appearance?
Thrombosed capillaries present when shaving down
1120
Milker's nodule pathogen
Parapox virus (PAR for FARmer)
1121
Orf pathogen
Also parapox virus (PAR for FARmer), but comes from sheep and goats
1122
Milker's nodule and orf Rx?
Nothing, reassure
1123
Erythema multiforme Rx?
Nothing, unless itchy can use CSC
1124
Lymphogranuloma venereum - STI association?
Chlamydia. Also causes proctitis (anal pain and discharge)
| Doxy 100mg bd for 21 days
1125
Mycoplasma genitalium Rx?
Doxycycline 100mg bd 7 days, then Azithromycin 1 g immediately then 500 mg daily for 3 days (total 2.5 g)
1126
Which STI should you high vaginal swab instead of endocervical?
Trichomonas
1127
Chancroid vs chancre difference
Chancroid = painful
1128
Chancroid cause?
haemophilus ducreyi
1129
Syphillis contact tracing
3 months (6 if secondary)
1130
Syphillis Rx?
Benzathine benzylpenicillin 2.4 million units IM stat
1131
Nebulised salbutamol dose
5mg nebules (2x in over 6yo) [10mg in adult]
1132
Nebulised ipatropium dose?
250mcg (2x in over 6yo) [500mcg adult]
1133
IV hydrocort dose for asthma?
100mg
1134
IV mg sulfate dose for asthma?
10mmol
1135
Ix for foreign body
Inspiratory and expiratory CXR
1136
Pernicious anaemia diagnosis with Ix
anti parietal cell antibody
| anti intrinsic factor antibody
1137
IBS Rx (2)
Hyoscine butlbromide 20mg QID PRN
| Fluoxetine 20mg daily/Amitriptylline 10mg daily
1138
Hyponatraemia + Pneumonia cause?
Legionella
1139
3 non-pharm Mx of SVT?
Valsalva
Cold water to face
Unilateral carotid sinus massage
1140
Patient amenorrhoeic on implanon/IUD. Dx menopause?
x2 FSH 6 weeks apart. >30
1141
What age should bedwetting start treatment for?
6 years +
1142
Conduct order adult version?
Antisocial personality disorder
1143
Metatarsal shaft fracture Mx?
```
1st = cast/ortho
2nd-5th = CAM boot, partial WB 6 weeks
```
1144
When to refer paediatric stuttering?
If it has been going on for more than 12 months
1145
When should TB testing be repeated if high suspicion?
8 weeks if initial test was negative
1146
What age do you refer to colp straight away for any abnormal HPV?
70-74
1147
When should UTI kids have follow up renal USS? (3)
Boys <3 months
Seriously unwell
Renal impairment
1148
What ages to give zoster immunoglobulin for kids at home?
<1 month only
1149
Which family contacts also need pertussis Rx?
Jobs/Living with exposure <6 months old
| Pregnancy
1150
When to incise thrombosed haemorrhoids?
Within 72 hours of symptoms, otherwise sitz bath
1151
Minimum isolation for chickenpox?
5 days
1152
Difference between NAFLD and NASH monitoring?
```
NAFLD = 6 monthly LFT's
NASH = 6 monthly liver USS and AFP
```
1153
Antidepressant during breastfeeding?
Sertraline
1154
Pharyngeal gonorrhoea Rx?
ceftriaxone 500mg IM and TWO GRAMS azithromycin stat
1155
What antipsychotics to avoid in Parkinson's
Risperidone, haloperidol and olanzapine
1156
When do you need to give tetanus toxoid vaccine?
>5 years since last shot + dirty/major wound
1157
What time frame to treat shingles?
<72 hours onset
1158
MSM how often to check for STI's
3 monthly unless monomagous relationship (12)
1159
Myasthenia Gravis Ix
Acetylcholine antibody
1160
Headache worse when standing, better on lying?
Post-lumbar headache
1161
Post-lumbar headache Mx? (2)
Analgesia
Resolves in 24 hours
Fluids
1162
What medications increase risk of benign intracranial HTN?
Doxycycline
1163
Benign intracranial hypertension Mx? (2)
Urgent referral to neuro
| Stop tetracycline/doxycycline
1164
3 causes of erythema multiforme
HSV
Medications - amoxicillin
Malignancy - Hodgkin's lymphoma
SLE
1165
Q fever Ix?
Coxiella burnetti PCR
OR
Antibody levels 2-3 weeks later
Q fever BURNS
1166
When to review child with AOM?
48-72 hrs
Either commence Amoxi if not improving, or if already on, step up to Aug DF
1167
Waxing + waning fever , returned traveller
Malaria
Thick and thin, waxing and waning = malaria "up and down"
1168
Step-ladder fever. Dx?
Typhoid
"AVOID walking under ladders, tyPHOID"
1169
How to Dx typhoid
Stool culture
ladder and stool are similar to get up
1170
Salmon coloured macules , returned traveller
Typhoid
Salmon coloured ladder
1171
Eschar in returned traveller
Typhus
1172
Hydrophobia, hyperactivity in returned traveller
Rabies
animals don't like water
1173
Gastrocnemius tear Rx?
Firm elastic bandage
1174
Post surgical disproportionate pain?
Complex regional pain syndrome
1175
4 underlying causes of bursitis?
```
infection
trauma repeated
Overuse
Pressure
arthritis (OA,gout,RA)
```
1176
3 management options bursitis
needle aspiration
NSAID's
compression
1177
Raynaud's Rx?
amlodipine 5mg
1178
Raynaud's Rx to avoid?
beta blockers
1179
erythromelalgia Rx?
aspirin
1180
4 precautions to NSAID's
```
active peptic ulcer disease/GI bleeding
eGFR <30
liver cirrhosis
established CVD (stroke/AMI)
planning pregnancy/pregnancy
```
1181
Voltage criteria for LVH?
V3 + V5 = more than 7 squares
1182
Mod risk CVD calc. When to start Rx?
ATSI
Family premature CVD
BP >160
Otherwise review in 3-6 months, if still mod, start Rx
1183
Low risk CVD calc. When to start Rx?
BP >160
Otherwise keep reviewing every 2 months
1184
How much LFT derangement until reducing statin?
>3x UNL
1185
What two conditions require lower pred dose for flares?
```
Gout = 15-30mg/day
PMR = 15mg/day - 1 month
```
1186
Symptoms for carcinoid syndrome? (4)
Flushing, diarrhoea, valvular heart disease, wheezing
1187
What situations to treat subclinical hypothyroidism immediately? (2)
TSH >10
| Anti-thyroid peroxidase antibody positive
1188
What medication can cause hyper/hypothyroidism
Amiodarone
1189
What medication can cause hypothyroidism only?
lithium
1190
Thyroiditis nuclear uptake results?
absent or low
1191
ASTI FBGL/HbA1c starting age?
18yo, annually
1192
What does DEXA stand for?
Dual energy xray absorption
1193
Post thrombotic syndrome prevention?
Compression Stockings for 18 months
1194
Breastfeeding CI for COCP?
Only if <6 weeks
1195
VTE factors CI for COCP?
first degree <45yo
PHx of VTE
Known thrombogenetic mutation
1196
What to do if someone develops migraine whilst on COCP?
Stop COCP
1197
Breast conditions CI for COCP?
PHx only (FHx doesn't matter)
New breast lump
BRCA gene positive
1198
When to repeat HPV if inadequate sample?
6-12 weeks
1199
How many negative tests do you need after HSIL treatment?
TWO negative CO-tests
1200
Do we need to do CST for hysterectomy?
Only if hysterectomy was for HSIL, needs 2 negative co-tests
1201
When to consider bariatric surgery for T2DM?
Poor control and BMI >35 or, BMI >40
1202
What HbA1c % do you need to start a second agent immediately with metformin?
8.5%
1203
After commencing ACEI in new CKD, when to review for AKI/K+?
within 2 months, (make sure less than 25%)
1204
What condition do you need to maximise ACE dose before adding 2nd agent?
CKD
1205
Aboriginal health Assessment MBS number?
715
1206
Acute rheumatic fever chronic Mx
Benzathine benzylpenicillin monthly for 10 years or 21yo. Whichever is later
1207
What age is everyone recommended to get extra boostrix?
50
1208
When do ATSI get adult prevenar dose?
50yo
1209
What medication to give when patient is on max dose of allopurinol and not reaching urate level target?
Probenacid (never use in Hx of kidney stones)
1210
How often to do Asthma cycle of care?
Twice per year
1211
How often to do T2DM cycle of care?
Annual at least
1212
Unable to straighten knee, and clicking of knee?
Meniscal bucket-handle tear
1213
According to SCAT5 concussion grading, how long between each step of rehab?
24 hours (1 day)
1214
Post-concussion, when to refer if symptoms still present?
2 weeks after incident
1215
XR doesn't show suspected fracture. When to choose MRI instead of CT?
```
CT = acute fracture
MRI = stress fracture
```
1216
What temp to avoid vaccination in?
>38.5
1217
Balanitis Rx?
Hydrocortisone 1% cream + clotrimazole 1% (if fungal suspected)
1218
Roseola causative organism?
Human herpes virus (no longer infectious after rash appears)
1219
Child can't perform motor tasks. Dx?
Dyspraxia
1220
Morton's neuroma Ex finding sign?
Mulder's sign (clicking when squeezing)
1221
When to repeat needlestick blds?
```
6 weeks (HIV only)
3 months and 6 months
```
1222
Trochlear nerve innervation
Superior oblique (medial and downwards eye movement)
1223
Premature CVD age?
<55yo
1224
When to refer for abnormal LFT's?
Persistent and
2x UNL for liver transaminases
1.5x UNL for liver phosphatases
1225
How long to continue anti-depressant for after commencing?
12 months
1226
How long to delay imaging in new radicular pain after lifting heavy item?
6 weeks.
After trial of conservative Rx, can consider imaging
1227
What age do we not consider HPV vaccination for catch up?
>19yo (likely already exposed)
1228
Campylobacter diarrhoea Rx?
Azithromycin (only in severe disease, otherwise self limiting)
Or pregnant, immunocompromised, infants
1229
AV nipping and silver wiring are exclusive to what type of retinopathy?
HTN
1230
New bright PR blood, when to organise c-scope regardless of what you examine?
40-50 (plus sigmoidoscopy)
| 50yo+
1231
Acute mania Rx within bipolar?
Olazapine/Haloperidol/Risperidone
1232
Akathisia Rx?
Propanolol
1233
Chorea + dementia + falls. Dx?
Huntington's
1234
Urinary incontinence + gait instability + dementia. Dx?
Normal pressure hydrocephalus
1235
Korsakoff triad?
Ataxia, eye movement abnormalities, confusion
1236
AAA surgical referral threshold?
>5cm (but can refer earlier for vasc to do surveillance themselves)
1237
Post herpetic neuralgia time frame?
3 months after shingles
1238
Standard neck circumference cut off for OSA?
40cm
1239
Weber A Mx?
CAM boot WBAT
1240
Weber B Mx?
Backslab NWB
1241
Weber C Mx?
Backslab NWB
1242
Gestation for chorionic villus sampling?
10-13 weeks
1243
Gestation for amniocentesis?
>15 weeks
1244
Fluid bolus for paeds?
20mL/kg stat
1245
What size ovarian cyst needs no further Mx?
<5cm (unless post-menopausal, = abnormal)
1246
Bullimia nervosa Rx?
Fluoxetine 20mg daily
1247
SLE Rx?
Hydroxychloroquine
1248
2 organisms that can grow in onychoLYsis?
candida (flucanozole) and pseudomonas (acetic acid)
1249
Urethral caruncle Rx?
Topical oestrogen
1250
Stress fracture suspected but nothing on XR?
Do MRI
1251
Oesophageal spasm Rx?
GTN sublingual
1252
Carotid artery stenosis level post stroke that needs operation?
>70%
1253
Pseudogout further Ix? (3)
CMP, ferritin, ALP
For haemachromatosis, and thyroid/calcium increasing causes
1254
Amoxicillin child dose?
15mg/kg
| 30 if pneumonia - double
1255
Pneumothorax chest drain site
2nd space MCL
1256
Heart Failure salt limitation?
<6g
1257
Immunocompromised + pneumonia
Pneumocystitis jirovecci pneumonia
Sulfamethoxazole+Trimethoprim
1258
Second episode of herpes STI?
500mg bd valaciclovir (THREE day course only)
1259
Preferred antiviral in pregnancy?
Aciclovir
1260
How much is high dose glucocorticoid therapy making someone eligible for a DEXA?
7.5mg or more /day for more than 3 months
1261
eGFR for automatically high risk CVD?
<45
1262
GAD timeframe?
>6 months
1263
BIpolar time frame
1 week
1264
Adjustment triggering event?
3 months
1265
What is the postural HR inrcrease warranting medical admission for eating disorders?
30 or more
1266
How many days before surgery should warfarin be ceased/bridged?
5
1267
How many days before surgery should DOACs be ceased for a HIGH-risk procedure?
2-3
1268
What are the two criteria for a high-risk episode (high chance of treatment failure) of acute otitis media in an ATSI child?
1. Children <2yo with fevers >38.5
| 2. Children <2yo with bilateral AOM
