Management of common conditions

Question 1

Constipation

Answer 1

Movicol Sachets

- not dietary first line

Question 2

Enuresis

Answer 2

• Rule out constipation, diabetes, UTI
• Star chart
• < 7: alarm
• > 7- Desompressin

Question 3

UTI

Answer 3

> 3 months = Trimethoprim 3 days
< 3 months = admit + cefuroxime IV
- re-assess 24-48hrs
(cephalosporin if > 3 and complicated)

Question 4

Eczema

Answer 4

Emollient - E45

Hydrocortisone 0.1% : 1 finger tip unit - 2 adult hands only put on affected area, avoid healthy skin

Question 5

Dehydration

Answer 5

Fluids

Oral rehydration fluids: 1-2mls/kg every 10 mins

Question 6

Pneumonia

• CAP + pen allergic
• HAP/Severe CAP
• Neonate

Answer 6

CAP 6months-18yrs: oral amoxicillin -7 days
Pen allergic: clarithromycin
- Co-amoxicalv or cefuroxime
Neonate: Gentamicin + benzylpenicilin

Question 7

Epiglottitis

Answer 7

• secure airway + O2
• Cefotaxime IV
• Dexamethasone
• Inhaled adrenaline

Question 8

Croup

Answer 8

• Dexamethasone 150 micrograms/kg
• Neb adrenaline 400micro/kg max 5 mg
  monitor 2-3 hours

Question 9

Meningitis

Answer 9

< 3 months: cefotaxime + amoxicillin IV
> 3 months: Ceftriaxone
Community benzylpenicillin 
- < 1 yr: 300mg 
- 1-9 600 mg 
- 10+ 1.2g

• 10 day treatment

Question 10

Sepsis

• < 72 hours neonate
• > 72 hour neonate
• 1 month - 18 yrs
• Hospital acquired
• Meth resistent

Answer 10

< 72 hours : Benzylpenicillin + gentamicin (covers Group B strep) - 7 days
> 72 hours: Amoxicillin + cefotaxime - 7 days
1 month - 18 years CA: cefotaxime - 5 days

HA: Tazocin (pipercillin + tazobactam) - 5 days
Methicillin resistant: vancomycin

Question 11

Fluids

Answer 11

• Bolus 20ml/kg 0.9% NaCL
• DKA: Bolus 10ml/kg 0.9% NaCL

Maintenance: 7.1 < 5% KCL
100ml -10kg > 10 KCL
50ml- 10kg
20 ml - every kg

Dehydration:
5/10% x weight x 10 - over 48 hours

Question 12

Septic arthritis

Answer 12

Flucloxacillin

Question 13

Impetigo

Answer 13

Fucidic acid

Question 14

Erysipelas (group A strep)

Answer 14

Phenoxymethylpenicillin PenV

Question 15

Chlamydia

Answer 15

Azithromycin 1g STAT

Question 16

Gonnorhoea

Answer 16

Azithromycin 1g STAT

Ceftriaxone IM

Question 17

Warts

Answer 17

Imiquimod

Question 18

Mastitis

Answer 18

Flucloxacillin

Question 19

UTI in pregnancy

Answer 19

Trimeth - after 1st

Nitro - avoid in third

Question 20

UTI in breast feeding

Answer 20

Trimethoprim

Nitro can cause haemolytic

Question 21

HSV

Answer 21

4 x weeks of oral acyclovir 4 weeks before birth
C-SECTION
Reassure

Question 22

Recap:
Which conditions do you prescribe cefuroxime?
Which conditions do you prescribe cefotaxime?
Which conditions do you prescribe ceftriaxone?

Answer 22

Cefuroxime: UTI, HAP pneumonia

Cefotaxime: Epiglottis, Meningitis, Sepsis >72 hours

Ceftriaxone: Gonnhorea