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Chapter 10-16 Nov 23 > Chapter 10-16 Nov 23 > Flashcards

Chapter 10-16 Nov 23 Flashcards

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1
Q

Question

A

Answer

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2
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Q1: What’s the maximum dose of methotrexate a person can take a week?

A
  • Severe Crohn’s disease (max 15mg weekly)
  • Moderate to severe active rheumatoid arthritis (max 20mg
    weekly)
  • Severe active rheumatoid arthritis (max 25mg weekly)
  • Severe psoriasis
    (max 30mg weekly under specialist supervision)
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3
Q

Q2: What is not recommended for osteoarthritis?

A
  1. Glucosamine,
  2. chondroitin, and topical rubefacients
  3. Intra-articular preparations of hyaluronic acid are available for osteoarthritis of the knee but are also not recommended.
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4
Q

Q3: What is rheumatoid arthritis?

A

Rheumatoid arthritis is a chronic systemic inflammatory disease

That causes persistent symmetrical joint synovitis
(inflammation of the synovial membrane)
typically of the small joints of the hands and feet.

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5
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Q4: What are the main symptoms of rheumatoid arthritis?

A
  1. Joint pain Stiffness,
  2. swelling,
  3. tenderness
  4. heat in the affected joints.
  5. Lasts for > 30 minutes.

Rheumatoid nodules Symmetrical: affects both sides Non-specific symptoms: malaise, fatigue, fever, and weight loss.

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6
Q

Q5: What does DMARD stand for?

A

Disease modifying anti-rheumatic drugs

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7
Q

Q6: What are the 4 most common drugs used in rheumatoid arthritis?

A
  1. Methotrexate,
  2. Azathioprine,
  3. Ciclosporin,
  4. Sulfasalazine
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8
Q

Q7: What are the less commonly used drugs in rheumatoid arthritis?

A
  1. Sodium aurothiomalate (Gold),
  2. Leflunomide,
  3. Penicillamine Antimalarilas
    (hydroxychloroquine/chloroquine)
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9
Q

Q8: If a patient starts on a DMARD, could it affect their NSAID dose?

A

Yes, it does
1. When used concomitantly with a DMARD, an NSAID should be used at the lowest effective dose.

  1. This is to reduce the risk of interactions, side effects and toxicity.
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10
Q

Q9: What are the main aims for treating RA with DMARD’s?

A

Stop it from getting worse
Reduce the symptoms of the disease

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11
Q

Q10: What is osteoarthritis?

A

Joint problem
Symptoms experienced only when the joint bears weight.
One sided
Morning stiffness lasts < 30 minutes

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12
Q

Q11: What are the main symptoms of osteoarthritis?

A
  1. Swelling of the joint
  2. Morning stiffness < 30 minutes
  3. Pain of the joint
  4. Grating or crackling sound of the joint when moving
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13
Q

Q12: What are the main drugs used to treat osteoarthritis?

A
  1. Paracetamol is always the 1st option
  2. If it affects the hands or need’s anti inflammatory drugs, we use capsaicin or a topical NSAID.
  3. Oral NSAID
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14
Q

Q13: If patients are already taking aspirin for pain due to osteoarthritis, what can be given after and why?

A
  1. opiate
  2. never give aspirin in combo with another NSAID
  3. Risk of GI bleeding, ulcers,
  4. renal damage and other side effects.
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15
Q

Q14: What lifestyle measures should be taken by people who have osteoarthritis?

A
  1. Lose weight
  2. Exercise
  3. Wear comfortable shoes
  4. Always maintain good posture
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16
Q

Q15: Which group of people should not take glucosamine?

A
  1. not recommended to treat osteoarthritis
  2. no solid evidence to prove it does anything.
  3. It should never be used in people allergic to shellfish
  4. It should be avoided in pregnancy
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17
Q

Q16: What is Gout and what are the key symptoms?

A
  1. A type of arthritis that affects the joints in the hand and feet
  2. Due to a build-up of urate crystals in these joints
  3. More common in men
  4. The key symptoms include:
  5. Swollen joints, especially hands and feet
  6. Tenderness
  7. Redness
  8. Warmth
  9. Pain * Needle like crystals forming in the joints
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18
Q

Q17: What are the risk factors for gout?

A
  1. Male gender
  2. Alcohol
  3. Organ meats
    **Drugs**:
    * thiazide diuretics, loop diuretics,
    * ethambutol,
    * pyrazinamide,
    * isoniazid and cytotoxics.

Recent injury or surgery of the joint * Current health problems: high blood pressure, kidney failure, diabetes and high cholesterol

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19
Q

Q18: What is used for the treatment of an acute gout attack?

A
  1. Colchicine or
  2. High dose NSAID is an alternative. Naproxen is a good choice. *

**Colchicine** MHRA warning:

fatal toxicity if overdose happens.

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20
Q

Q19: What’s used for the long term management of gout?

A
  1. Allopurinol always 1st line
  2. Febuxostat if allopurinol not suitable
  3. Sulfinpyrazone or benzbromarone

(specialist after no success with allopurinol or febuxostat)

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21
Q

Q20: What’s the main CI’s of colchicine?

A

Any kind of blood disorder
Pregnancy
EGFR < 10

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22
Q

Q21: What dose of colchicine should be used for gout?

A

Comes is 500mcg strength *
1 tablet (500mcg) 2-4x a day *
Maximum 3 day’s worth of treatment *
Maximum supply: 12 tablets.

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23
Q

Q22: What’s the maximum number of colchicine tablets to be used for gout?

A

**12 **
Always remember 12

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24
Q

Q23: Which drugs should be avoided when on colchicine for gout and why?

A

Avoid the enzyme inhibitors:
GAVID SICKFACES.COM *

Enzyme inhibitors cause colchicine toxicity, because they raise colchicine levels in the body. *

Avoid anything that causes diarrhoea (CALM D) *

Avoid the liver toxic drugs. *

Statins should be avoided due to muscle death

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Q24: What's the main MHRA warning on febuxostat?
1. Hypersensitivity reactions such as anaphylaxis 2. SJS (steven johns syndrome). If this happens,` stop `and` see GP` * Increased risk of cardiovascular death in patients with history of cardiovascular problems.
26
Q25: What's myasthenia gravis and what are the main treatments for it?
Muscle weakness especially of the eye muscles * Main treatments: 1. Neostigmine 2. Pyridostigmine
27
Q26: What's the main advice regarding treatment cessation of Baclofen for muscle spasms?
****don’t stop abruptly **** can cause 1. hyperthermia, 2. hallucinations and 3. worsen the spasms * Always reduce the dose gradually over 1-2 week intervals.
28
Q27: What can be used as an alternative to baclofen for muscle spasms?
Methocarbamol
29
Q28: Give examples of NSAID’s?
1. High dose aspirin * 2. indomethacin * Anything ending with the following: `Profen `* `Fenac * ` `Fenamate ` `fenamic` `acid ` `Oxicam` * `Proxen` * `Coxib`
30
Q29: What’s the main counselling points for NSAID’s?
1. Never take more than TDS 2. Always take it with food or full stomach **Report any warning signs such as**: 1. Dark stools 2. coffee coloured vomit * 3. Worsening of asthma * 4. GI bleeding * 5. Anemia * 6. Weight loss and unable to swallow * 7`. Swollen ankles and fee`t * Any patients with any kind of arthritis or over 45 should be given `PPI` with it.
31
Q30: What can NSAID’s worsen the symptoms of?
1. Asthma: for NSAIDS this is a caution or a CI depending on the NSAID NSAIDS can also worsen the symptoms of heart failure as NSAIDS are contraindicated in heart failure
32
Q31: What are the selective and nonselective NSAIDS and what’s the difference?
Selective NSAIDs: less GI side effects but they have more CV effects (coxibs) Non Selective: more GI side effects but less CV effects (Ibuprofen)
33
Q32: Which NSAIDS are associated with a higher CV risk?
****Selective NSAIDs are always associated with more CV risks.**** * Higher doses of NSAIDs are also associated with CV risk. * `Coxibs` have the highest risk and `profens` have the lowest risk.
34
Q33: What are the main CI and side effects of NSAID’s?
C/I: Active GI bleeding, P+BF, heart failure, heart disease IBD. S/E: GI ulcers, GI bleeding and sensitivity reactions.
35
Q34: What are the main uses of NSAID’s?
1. Pain * 2. Fever (pyrexia) 3. Rheumatic disease 4. Muscle pain. 5. Acute Gout attacks
36
Q35: What are the ibuprofen doses for children 3 months to 12 years?
(See detailed dosing table)
37
Q36: What are the paracetamol doses for children 3 months to 12 years?
* 3 months to 6 years we always use 120mg/5ml * For 6 years and above we use 250mg/5ml. * Remember the dose in ml always increases by 2.5ml and the age intervals do overlap * Remember it’s max 4x a day * Use the amount in ml to calculate mg * Remember that it’s 3 months, 6 month and 24 months = 2.5ml and 5mll * Remember that the ages 2 years and above increase in increments of 2 years. 2-4 years (7.5ml) and 4-6 years (10ml). * Remember that the 6-8 years (5ml), 8-10years (7.5ml) and 10-12 years (10ml) * Practice drawing the table on the right and you’ll be fine. Ages 3 months-6 years (120mg/5ml) 3-6 months 2.5 6-24 months 5 2-4 years 7.5 4-6 years 10 Ages 6-12 years (250mg/5ml) 6-8 5 8-10 7.5 10-12 10 (See detailed dosing table)
38
Q37: What dose of chloramphenicol would you give to someone with bacteria conjunctivitis?
* 1 drop every 2 hours in the affected eye for 2 days * 1 drop every 4 hours for the remaining 3 days 5 day course
39
Q38: What are the main counselling points regarding the use of eye drops in general?
* Always wash your hands before using them. * Make a pocket with your eye lid and squeeze a drop in there. * Blink and keep the eye closed for 2 minutes * If you want to use more than 1 eye drop, you need to wait for 5 minutes. You can’t use more than 1 drop at the same time. * Keep the dropper clean and never touch your eye with it. * Don’t drive until vision is okay * Throw the drops away after 28 days. (See detailed counseling points)
40
Q39: What eye drops are used for allergic conjunctivitis?
Antihistamine eye drops * Sodium cromoglycate This is not an infection so they won’t use antibiotics.
41
Q40: What's used for the prevention and treatment of inflamed eyes not a result of infection?
NSAID eye drops such as diclofenac
42
Q41: What is blepharitis and what are the key symptoms to look for?
Blepharitis is often caused by staphylococci. * swollen, sore eyelids * itchy eyes eyelids * a gritty feeling in the eyes * flakes or crusts around the roots of the eyelashes * eyelids sticking together in the morning when you wake up * It’s not usually serious and can often be treated by washing your eyelids every day.
43
Q42: What are the main treatments for blepharitis?
* First line treatment is just good eye hygiene by giving it a good wash * Good eye hygiene should be carried out 2x a day and then once daily when the symptoms are easing. * Is it’s not cured by a good eye wash use treatments such as: * Chloramphenicol * Propamidine isethionate * Dibrompropamidine isethionate * Patients should avoid any eye paints and mascara as it can make it all worse. (See detailed treatments)
44
Q43: What are the main lifestyle points for people with blepharitis?
* Clean your eyelids twice a day with an eye pad or cotton bud or wool, Soak a clean flannel or cotton wool in warm water and place it on your closed eyelid for 5 to 10 minutes. * Gently massage your eyelids for around 30 seconds. * Clean your eyelids using cotton wool or a cotton bud. It might help to use a small amount of baby shampoo in water. Gently wipe along the edge of your eyelids to remove any flakes or crusts. * then once a day as your symptoms improve continue to clean your eyes, even if your symptoms clear up * Avoid eye make up and mascara as that makes it worse.
45
Q44: What is conjunctivitis and what are the key symptoms to look for?
* Inflammation of the conjunctiva * Various causes: Bacteria, Viral, Allergy Symptoms and Diagnosis: * Bacterial: it can either affect 1 or both eyes. Yellow discharge and self limiting. May need antibiotics if it last longer than a week. * Viral: always affects both eyes, gritty, watery discharge, and other cold and flu like symptoms as well. * Allergy: both eyes affected, irritation, watery discharge and discomfort.
46
Q45: What are the main treatments for conjunctivitis?
* For bacterial: Chloramphenicol, propamidine isethionate (safe in all ages and for pregnancy and breastfeeding) * For allergic: sodium cromoglicate * For viral: artificial tears and simple pain killers * Refer if: * Vision affected * Glaucoma * No improvement after 2 days * P+BF * Photophobia * Eye pain * Dry eye syndrome
47
Q46: What are the main lifestyle points for people with conjunctivitis?
* Wash hands after touching eye, * Conduct good eye hygeine * Do not share towels/pillows, * Avoid wearing contact lenses during treatment * It’s self limiting so piss off. No antibiotics.
48
Q47: What is glaucoma?
* Glaucoma is a group of eye disorders characterised by a loss of visual field associated with pathological cupping of the optic disc and optic nerve damage. * It is generally associated with high intraocular pressure (IOP), although it can still occur when the IOP is within range.
49
Q48: What drugs are used to treat glaucoma?
* The aim of treatment: to control intraocular pressure to prevent the development or progression of glaucoma, and subsequent visual field damage or sight loss. The classes of drugs: * Topical prostaglandin analogue: latanoprost, tafluprost, travoprost, or bimatoprost. * Topical beta blocker: betaxolol, levobunolol, timolol. * Carbonic anhydrase inhibitors: brinzolamide, dorzolamide. * Topical sympathomimetic: apraclonidine (unlicensed) or brimonidine. * Topical miotic: pilocarpine (unlicensed) (See detailed list of drugs)
50
Q49: What are the main side effects of antiglaucoma drugs?
* The side effects of these drugs are usually local although systemic SEs might occur with certain eye drops. * Common SE seen: * Eye discomfort, * Eye inflammation, * Eye disorders. * Vision disorders * It is best to consult literature for each specific drug. (See general side effects)
51
Q50: What is the most common preservative in eye drops?
Benzalkonium chloride
52
Q51: What is anterior uveitis and what is used to treat it?
* Anterior uveitis is an inflammation in the middle layer of the eye. * Symptoms: red, sore & inflamed eye; blurred vision, sensitivity to light, small or irregular-shaped pupil. Drug Treatment: Topical antimuscarinics: E.g. atropine, cyclopentolate, homatropine. Anti-inflammatory: for treating inflammation.
53
Q52: What is subconjunctival haemorrhage, what used to treat it and when should you refer?
* This is described as when the tiny blood vessels between the conjunctiva and sclera burst. Could be all of the eye or only certain parts. * No treatment is required as will fade away generally within 2 weeks. * Refer if patient is on anticoagulants, also very high blood pressure.
54
Q53: What are the key symptoms of keratitis and what are the treatments?
* Keratitis is an infection that affects the cornea. * Symptoms: eye pain, sensitivity to light, red eye, watery eye, and blurred vision. * Treatment is dependent on cause of infection (bacterial/fungal/viral). (See detailed description and treatment)(See detailed description and treatment)
55
Q54: What are the universal red flag symptoms of eye problems?
* Pain in the eye (different from eye discomfort or itching) * Photophobia * Poor vision * Pus discharge from cornea * Pupil abnormality * Foreign body in the eye (See detailed list of red flag symptoms)
56
Q55: What is Otitis externa and what’s used to treat it?
* Outer ear canal infection characterised by itching, redness and swelling. * Can be treated OTC but sometimes you’ll need antibiotics OTC treatments Antibiotics ● Acetic Acid (ear calm) ● Painkillers: paracetamol and ibuprofen ● Pseudomonas suspected (Ciprofloxacin or gentamicin) ● Penicillin tolerant: Flucloxacillin ● Penicillin Allergic: Macrolides (See detailed description and treatment)
57
Q56: What is Otitis media, what are the symptoms and what’s used to treat it?
* It is an infection of middle ear that causes inflammation and build-up of fluid behind eardrum * Symptoms - ear pain, fever, irritability, cough and rhinorrhoea (runny nose) * Self-limiting, viral leave it bacterial might need antibiotic OTC treatments Antibiotics ● Acetic Acid (ear calm) ● Painkillers: paracetamol and ibuprofen ● Penicillin Tolerant: Amoxicillin first line, then co amoxiclav if no improvement after 2-3 days. ● Penicillin allergy:Macrolides (EC) ● Last line: refer to microbiology (See detailed description, symptoms, and treatment)
58
Q57: When is it time to remove ear wax and what can you use to remove ear wax?
* Only remove if causes hearing loss or can’t look into ear * Can use olive / almond oil ear drops * Can also use sodium bicarbonate * Leave the drops in the ear overnight * Use syringe to wash it out the following day (See detailed guidelines for ear wax removal)
59
Q58: What is rhinitis and what are the causes and symptoms of each cause?
(See detailed description of rhinitis causes and * A reaction that causes nasal congestion, runny nose, sneezing and itching * Allergic (caused by trees/grass pollen) - blocked/runny nose and itchiness * Non allergic - blocked/runny nose and sneezing symptoms)
60
Q59: What’s used to treat rhinitis?
* Antihistamines /topical nasal corticosteroids
61
Q60: What’s the maximum supply of ephedrine preparations in terms of pack size and mg?
180mg in a single transaction • 1 pack - 12 tablets
62
Q61: Which drugs cause dry mouth?
COPD Meds: GUTA I * Antipsychotics * Trospium * Sedating antihistamines: HD-CAP * TCA’s * Drugs for urinary incontinence/frequency: DOTS * Hyoscine * Trihexyphenidyl * Cyclizine * Baclofen * Nefopam (See list of drugs causing dry mouth)
63
Q62: What’s the main problems associated with dry mouth?
Tooth decay and infection of gums
64
Q63: What are the main treatments for dry mouth and what preparations do they come in?
* ACBS, bioxtra, glandosane, saliva orphans and saliveze * Mouthwash, lozenges and sprays (See list of dry mouth treatments)
65
Q64: What's used to help the treatment of gum disease and mouth infections?
Chlorhexidine mouthwash
66
Q65: What's the main side effect of chlorhexidine?
Reversible brown staining of teeth and tongue (prolonged use only)
67
Q66: What's used for mouth ulcers and inflammation?
(See list of treatments for mouth ulcers)
68
Q68: What is used to treat dental abscesses?
Amoxicillin/Metronidazole (5 days course, 1tds)
69
Q69: What is used to treat periodontitis?
Metronidazole or Doxycycline (if over 12)
70
Q70: What is used to treat a sore throat?
- Viral: self-limiting, use benzydamine and other symptomatic relief. Ice chips to suck on.
- Bacterial: phenoxymethylpenicillin or clarithromycin (5 days course).
- Benzydamine: Over 12.
- Lidocaine: Over 12.
- Benzocaine: Over 6.
- Flurbiprofen: Over 12.
71
Q71: What does ACBS stand for and what is their function?
- ACBS stands for Advisory Committee on Borderline Substances.
- Their function is to advise the NHS on specially formulated items for medical conditions.
72
Q72: What body parts are applications most used on?
- Scalp and nails.
73
Q73: What's the difference between creams and ointments?
- Cream: An emulsion of oil in water, less greasy, easy to apply.
- Ointment: Greasy, insoluble in water.
74
Q74: What bath item should be avoided in people with dry skin?
- Soap.
75
Q75: What's the MHRA warning for paraffin?
- Risk of fire with a build-up of paraffin on clothes and bedding.
- Don't smoke or go near naked flames.
- Wash at high temperature.
76
Q76: What is used to treat nappy rash?
- 1st line: Change nappies frequently.
- 2nd line: Clotrimazole 1% (if bright red rash).
- 3rd line: Zinc oxide cream/ointment (Sudocream).
77
Q77: Name some bacterial skin infections and their symptoms and treatments?
- Cellulitis: Painful, hot, and swollen skin; treated with amoxicillin or clindamycin/macrolide in case of allergy. - Impetigo: Red, itchy sores that break open and leak clear fluid or pus; treated with fusidic acid/mupirocin.
78
Q78: Name some fungal skin infections and their symptoms and treatments?
- Ringworm: Rash can appear anywhere on the body, including scalp and groin, usually ring-shaped; treated with clotrimazole and miconazole.
- Athlete’s foot: Itchy white patches between toes; treated with terbinafine hydrochloride 1%.
- Nail: Usually affects toenails, making them brittle and yellow; treated with amorolfine 5%.
79
Q79: Name some viral skin infections, their symptoms, and treatments?
- Shingles: Infection with a painful rash, tingling, and headache; treated with aciclovir.
- Warts: Small grainy bumps, rough to touch; treated with salicylic acid solution.
- Cold sores: Treated with aciclovir.
80
Q80: What’s used for the treatment of scabies?
- Permethrin.
- Treat everyone at the same time.
- Children over 2: Applied to the whole body but not the head to face.
- Children under 2 and the elderly: Apply it everywhere.
81
Q81: What’s the counseling advice with regards to using permethrin for scabies?
- Aged 2 and above: Apply everywhere except the face and head.
- Aged 2 and below: Apply everywhere.
- Treat all family members at the same time.
- Treat everyone a week later as well to eradicate parasites.
82
Q82: What’s used to treat head lice, and what’s the advice around each treatment?
- Permethrin can also be used in cases of crab lice.
- Avoid flames as you can get serious burns.
- Treat the whole family at the same time.
83
Q83: What is eczema, and what are the main complications associated with eczema?
- Eczema is a skin condition characterized by itching and inflammation.
- Main problems associated with eczema include skin infections and lichenification.
84
Q85: What’s psoriasis, and which drugs make it worse?
- Psoriasis is a skin condition that causes flaky patches of skin with scales.
- Drugs that can make psoriasis worse include lithium, some antimalarial medicines, anti-inflammatory medicines including ibuprofen, and ACE inhibitors used to treat high blood pressure.
85
Q86: What medicines are used to treat psoriasis?
- Topical treatment options include emollients, topical corticosteroids, coal tar preparations, topical vitamin D or vitamin D analogues.
- Methotrexate and Ciclosporin, among others, may be offered to some patients with severe psoriasis if topical treatment is not effective.
86
Q87: What corticosteroids are most and least potent?
1. - Mild: `Hydrocortisone. ` 2. Moderate: Low-strength `betamethasone` and `clobetasone.` 3. Potent: High-strength `betamethasone `and` mometasone.` 4. Very potent: `Clobetasol.`
87
Q88: What’s acne, and what is used to treat it?
Acne is a common inflammatory skin condition Treatment options include **1. adapalene with benzoyl peroxide, 2. tretinoin with clindamycin, 3. benzoyl peroxide with clindamycin,** and more depending on the severity.
88
Q89: What type of immunity do vaccinations give?
- Active immunity.
- Passive immunity.
89
Q90: What are the 3 types of vaccine?
- Live attenuated form of the virus.
- Inactivated preparations of the virus.
- Extracts of a microorganism.
90
Q91: Which type of vaccine should never be given to a certain group of patients?
Live vaccines should not be given to immunocompromised patients, HIV patients Patients on immunosuppressive medication.
91
Q92: What type of vaccine is the MMR and BCG vaccine?
- Both MMR (measles, mumps, and rubella) - BCG (Bacillus Calmette-Guérin) - vaccines are live attenuated.
92
Q93: What type of vaccine is the annual flu vaccine?
Inactivated form of the virus when given via injection. Nasal flu vaccine is live.
93
Q94: What type of vaccine is the COVID and meningitis vaccine?
COVID-19 vaccines use the spike protein of the SARS-CoV-2 virus to act as an intracellular antigen. Meningococcal vaccines protect against specific strains and can be live or inactivated.
94
Q95: Which 6 things does Infanrix hex cover and when should it be given?
Infanrix hexa covers 1. diphtheria, 2. tetanus, 3. pertussis, 4. hepatitis B, 5. poliomyelitis, and 6. haemophilus influenzae type b. It is administered at 8, 12, and 16 weeks.
95
Q96: What is the PCV vaccine, and which age group does it cover?
The PCV (Pneumococcal Conjugate Vaccine) Used to vaccinate children under 2 years old Part of the NHS vaccination schedule.
96
Q97: What is the PPV vaccine, and which age group does it cover?
PPV (Pneumococcal Polysaccharide Vaccine) is given at 65 years of age.
97
Q98: What is the MMR vaccine, and which age group does it cover?
MMR (measles, mumps, and rubella) vaccine is given at 1 year and 3 years and 4 months.
98
Q99: When should the Men B vaccine be given?
The Men B vaccine should be given at 8 weeks, 16 weeks, 1 year.
99
Q100: When should the rotavirus vaccine be given?
Rotavirus vaccine (Rotarix) should be given at 8 weeks, 12 weeks, sometimes to pregnant women.
100
Q101: When should the nasal flu vaccine and the HPV vaccine be given?
- - Nasal flu vaccine: - For children aged 6 months to 17 years. HPV vaccine: First dose offered to individuals aged `**12-13 years**` in England, Wales, and Northern Ireland, Aged 11-13 years in Scotland.
101
Q102: Which high-risk people can get the annual flu jab?
- People aged 50 and over.
- Those with certain health conditions (chronic respiratory, heart, kidney, liver, and neurological disorders).
- Pregnant individuals.
- Residents of long-stay residential care.
- Carers and those living with individuals more likely to get infections.
- Frontline health or social care workers.
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Q103: What is malignant hyperthermia, and what is used to treat it?
- Malignant hyperthermia is a rare but potentially lethal complication of anesthesia. - - It is characterized by a rapid rise in temperature, increased muscle rigidity, tachycardia, and acidosis. - - The trigger is suxamethonium chloride, and it is treated with dantrolene sodium.
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Q104: Which drugs must be stopped or changed before surgery?
1. Stop CHC and MAOIs. 2. Stop Lithium (before major surgery). 3. Stop K+ sparing/ACE & ARBs/herbal meds (24 hours before). 4. Stop antiplatelet/oral anticoagulant. 5. Give heparin/LMWH as an alternative.
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Q105: Which drugs can still be taken before surgery?
1. ANTI-epileptics, -parkinsonian drugs, -psychotics. 2. ANXIOLYTICS. 3. BRONCHODILATORS. 4. CARDIOVASCULAR DRUGS 5. (except for ACE/ARB, potassium-sparing diuretics).
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Q106: What’s used for the sedation of dental pain?
- Diazepam. - Temazepam.
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Q107: What factors determine the dose of an anesthetic?
- Injection site.
- Patient age.
- Patient weight.
- Patient physique.
- Clinical condition.
- Duration.
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Q108: When someone is poisoned with anything, what is the best thing to do as a general principle?
Manage the symptoms to stabilize the toxic effects of whatever the poison is. ****Seek more information from sources like **** 1. TOXBASE.ORG 2. NPIS (National Poisons Information Service).
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Q109: What are the key symptoms of someone being poisoned?
- Ataxia (lack of coordination).
- Slurred speech.
- Involuntary eye movements (nystagmus).
- Hypoglycemia.
- Hyperventilation.
- Tinnitus.
- Vasodilation.
- Liver damage.
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Q110: What do you use to treat hypotension as a result of being poisoned?
- Sodium chloride.
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Q111: What do you use to treat hypertension as a result of being poisoned?
- IV antihypertensives.
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Q112: What do you use to treat respiratory poisoning by CO?
- Oxygen.
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Q113: What do you give if someone is having convulsions as a result of poisoning?
- IV lorazepam or diazepam - (slow infusion, avoid IM route). - Oromucosal midazolam if IV route is unsuitable.
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Q114: Which drugs can be chelated with charcoal if someone is poisoned by them?
- Carbamazepine.
- Dapsone.
- Phenobarbital.
- Quinine.
- Theophylline.
- Calcium channel blockers.
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Q115: Which drugs require hemodialysis if someone is poisoned by them?
- Lithium.
- Ethylene Glycol.
- Salicylate (aspirin and amino salicylates).
- Sodium valproate.
- Phenobarbital.
- Methanol.
- LESS PM = hemodialysis (mnemonic).
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Q116: What is given if someone is poisoned, and their blood becomes acidified?
- Salicylates (e.g., salicylic acid) can cause blood to become acidified. - Something alkaline, like sodium bicarbonate, can help restore the pH.
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Q117: When can stomach pumping be given?
-Stomach pumping can be done directly from the GI tract if the poison has been taken in the last hour. This is rarely done.
117
Q118: What do you give if someone is poisoned by overdosing on MR or EC Preparations?
* WHOLE bowel irrigation (clean the entire bowels) is needed because * MR preparations release their active content gradually over time, and * EC preparation bypasses the stomach and releases active content in the bowels.
118
Q119: What are the symptoms of alcohol poisoning?
- Ataxia (lack of coordination).
- Dysarthria (slurred speech).
- Nystagmus (involuntary eye movement).
- Drowsiness.
- Hypoglycemia.
119
Q120: What are the symptoms of paracetamol poisoning, and what is used to treat it?
- Paracetamol poisoning can cause liver damage. - It is treated with acetylcysteine.
120
Q121: What are the symptoms of aspirin poisoning?
- Hyperventilation (rapid breathing).
- Tinnitus (ringing in ears).
- Deafness.
- Vasodilation (dilated blood vessels).
- Sweating.
121
Q122: What are the symptoms of opioid poisoning, and what is used to treat it?
Opioid poisoning can lead to 1. coma, 2. respiratory depression, 3. pinpoint pupils, a 4. Treated with naloxone.
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Q123: What's used for methotrexate poisoning?
`Folinic `acid is used for methotrexate poisoning.
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Q124: What are the signs of TCA poisoning?
TCA poisoning can lead to dry mouth, hypotension, hypothermia, dilated pupils, urinary retention, and arrhythmias. ****TCA stands for Toxicity, Cardiac, Anticholinergic, and seizures.****
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Q125: What are the signs of SSRI poisoning?
SSRI poisoning can cause nausea, vomiting, agitation, tachycardia, and bleeding.
125
Q126: What are the signs of antimalarial poisoning?
Antimalarial poisoning can lead to arrhythmias and convulsions.
126
Q127: What are the signs of antipsychotic poisoning?
- First-generation antipsychotics (e.g., Haloperidol) can cause hypotension, hypothermia, tachycardia.
- Second-generation antipsychotics (e.g., quetiapine) can cause drowsiness, extrapyramidal symptoms, and QT interval prolongation (leading to arrhythmias).
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Q128: What are the signs of benzo poisoning, and what is given to treat it?
- Benzo poisoning can lead to drowsiness, ataxia (lack of coordination), dysarthria (slurred speech), nystagmus (involuntary eye movement). It is treated with flumazenil.
128
Q129: What are the signs of beta-blocker poisoning?
- Beta-blocker poisoning can cause lightheadedness, dizziness, bradycardia, and hypotension.
129
Q130: What are the signs of CCB poisoning?
- CCB (Calcium Channel Blocker) poisoning can result in hyperglycemia.
130
Q131: What are the signs of iron poisoning, and what is given to treat it?
- Iron poisoning can cause N&V, abdominal pain, diarrhea, rectal bleeding, liver failure, and is treated with desferrioxamine (chelates iron).
131
Q132: What are the signs of theophylline poisoning, and what is given to treat it?
- Theophylline poisoning can lead to vomiting, dilated pupils, tachycardia, hyperglycemia, and hypokalemia. It is treated with repeated charcoal.
132
Q133: What are the signs of lithium poisoning?
- Lithium poisoning can cause N&V, arrhythmias, diarrhea, seizures, coma, fine tremor, blood pressure changes, renal failure, hypothyroidism.
133
Q134: What are the signs of stimulant poisoning?
- Stimulant poisoning can lead to wakefulness, hypertension, paranoia, dilated pupils, and sweating.
134
Q135: What is given to treat digoxin poisoning?
- Digoxin-specific antibody (DIGIFAB) is used to treat digoxin poisoning.
135
Q136: What is used to treat heparin and warfarin poisoning?
- Heparin can be treated with protamine, while warfarin can be treated with phytomenadione (vitamin K1).
136
Q137: What's used for the treatment of snake bites?
- Antiserum/antivenom is used to treat snake bites.
137
Q138: What is used for the treatment of DOAC anticoagulant poisoning?
- Rivaroxaban and apixaban can be treated with andexanet alpha, while dabigatran can be treated with idarucizumab.
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Chapter 10-16 Nov 23 (1 decks)

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