KFP MegaQuiz – Olympus Q&A

Question 1

Initial pharmacological management of psoriasis?

Answer 1

• Topical corticosteroids: anti-inflammatory and anti-proliferative
• Tars: anti-inflammatory and anti-pruritic
• Keratolytics: combined with tars to soften and lift scale
• Calcipotriol: results not immediate - can take up to 6 weeks to see clearance

Question 2

What are some triggers and exacerbators for psoriasis?

Answer 2

• Drugs: ACEi, Beta blockers, NSAIDs
• Infections: e.g. streptococcal, viral (including HIV), skin trauma (e.g. Kobner phenomenon)
• Stress
• Alcohol
• Sunburn
• Metabolic factors: calcium deficiency
• Hormonal factors: e.g. pregnancy, postpartum

Question 3

What are some comorbidities of psoriasis?

Answer 3

• Cardiovascular disease and its risk factors
• Psoriatic arthritis
• Inflammatory bowel disease
• Ocular disease

Question 4

What is the preferred treatment for chronic stable psoriasis on the trunk and limbs?

Answer 4

• Tar preparation: Coal tar 4 to 8% + salicyclic acid 3% cream or ointment topically, twice daily for 1 month
• Add topical corticosteroid in an acute flare or if coal tar prep alone is not sufficient
  
  • Methylprednisone aceponate 0.1% cream daily TOP until clear OR
  • Mometasone furoate 0.1% daily TOP until clear
• If response is inadequate after 3 weeks, use a more potent topical corticosteroid: betamethasone diproprionate

Question 5

In trunk and limb psoriasis treatment, what are the indications for calcipotriol + betamethasone diproprionate 50+500microgs/g ointment or foam TOP daily?

Answer 5

• Only a few scattered plaques that do not respond to coal tar preparation
• Need long-term control with a topical corticosteroid

Question 6

Which groups of people are at higher risk of a sexually transmitted infection?

Answer 6

• Had sex overseas
• Have been sleeping rough or homeless
• Worked as a street-based sex worker
• Had tattoos, especially overseas
• Injected drugs or used methamphetamines, especially if they shared needles or any of the equipment used for injecting
• Have been in prison
• Have been a refugee or recent migrant
• Identify as Aboriginal or Torres Strait islander
• Experienced violence from a partner
• Have been on PrEP
• Have been sexually assaulted or had sex they didn’t want to have

Question 7

Treatment for uncomplicated pharyngeal gonorrhoea?

Answer 7

• Ceftriaxone 500mg IM in 2mL of 1% lignocaine PLUS
• Azithromycin 2g PO STAT (or 1g followed by 1g 6 hours later to reduce GI side effects)

Question 8

Non-pharmacological management for gonorrhoea?

Answer 8

• Advise no sexual contact for 7 days after treatment is commenced, or until course is completed and symptoms resolved, whichever is later
• Advise no sex with partners from the last 2 months until the partners have been tested and treated if necessary
• Notify the state or territory health department
• Recommend partner notification

Question 9

What is required for test of cure and re-infection for gonorrhoea?

Answer 9

• TOC: For each side of infection (pharyngeal, anal or cervical), TOC by NAAT shoulder be performed 2 weeks after treatment is completed
• Re-infection: retest in 3 months