Common/emergency Conditions

Question 1

Hypoglycaemia

Answer 1

Dextrose 5%

Question 2

Hypertension

Answer 2

Under 55:
Step 1 - ACEi (if not tolerated ARB, if not tolerated BB)
Step 2 - add a calcium-channel blocker (if heart failure give thiazide-related diuretic).
Step 3 -

Question 3

CV risk reduction

Answer 3

Aspirin (secondary prevention) - 75mg daily

Statins

Question 4

ACS

Answer 4

Aspirin 300mg

Question 5

Ischaemic stroke/TIA secondary prevention

Answer 5

Aspirin + dipyridamole 25/200mg twice daily

Question 6

Diabetes mellitus type 2, overweight

Answer 6

Metformin 500mg with breakfast

Question 7

Acute asthma

Answer 7

1. Salbutamol + oral pred (if moderate) or IV (if life threatening)
   Second line: ipratropium
   Third line: IV aminophylline (if life threatening)

Question 8

Delirium tremens

Answer 8

Oral lorazepam

Question 9

Status epilepticus - adult

Answer 9

IV lorazepam 4mg

Question 10

Diabetes mellitus type 2, normal weight

Answer 10

Sulphonylurea e.g. gliclazide 40mg with breakfast

Question 11

Diabetes mellitus, creatinine > 150

Answer 11

Gliclazide 40 mg with breakfast

Question 12

Focal seizures

Answer 12

Carbamazepine

Question 13

All seizures other than focal

Answer 13

Sodium valproate

Question 14

Crohn’s flare

Answer 14

Mild - prednisolone 30mg

Severe - hydrocortisone 100mg IV 6 hourly

Question 15

Maintaining remission in Crohn’s

Answer 15

Azothioprine (check TPMT levels first, if low consider methotrexate instead)

Question 16

RA

Answer 16

Methotrexate + a DMARD

Question 17

RA flare

Answer 17

IM methyl prednisolone 80 mg

Question 18

Fever

Answer 18

Paracetamol

Question 19

Constipation

Answer 19

Laxative - never give a laxative if evidence of obstruction

Question 20

Diarrhoea

Answer 20

Loperamide 2mg up to 3 hourly, unless infection

Question 21

Insomnia

Answer 21

Zopliclone 7.5mg oral (3.75mg in elderly)

Question 22

Occulogyrate crisis from neuroleptic malignant syndrome

Answer 22

Procyclidine

Question 23

COPD exacerbation

Answer 23

Oxygen, salbutamol, ipratropium, oral prednisolone

Question 24

Reflux

Answer 24

Omeprazole 10 mg

Question 25

Scarlet fever

Answer 25

Phenoxymethylpenicillin 125mg for 10 days

Question 26

Bradycardia

Answer 26

Atropine

Question 27

Ipratropium, tiotropium

Answer 27

Antimuscarinic bronchodilators

Question 28

Acute pulmonary oedema

Answer 28

Loop diuretic (furosemide)

Question 29

Hyperkalaemia

Answer 29

1. Stabilise myocardium with 10mL 10% calcium gluconate

2. Glucose + insulin (100ml 20% glucose + actrapid), then salbutamol nebs

Question 30

Hay fever, pruritis

Answer 30

Antihistamine e.g. loratidine