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PSA > Planning management > Flashcards

Planning management Flashcards

1
Q

Management of acne vulgaris

A

1) Single topical therapy (BPO, topical retinoids)

2) Topical combination therapy (BPO + topical antibiotic or topical retinoid

3) Oral antibiotics (tetracycline, lymecycline, oxytetracycline, doxycycline)
COCP can be an alternative for women

4) oral isotretinoin

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2
Q

Typical antipsychotics: important side effects

A

EPSEs: Parkinsonism, acute dystonia, akathisia, tardive dyskinesia

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3
Q

Specific risk of antipsychotics in the elderly

A

Increased risk of VTE and stroke

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4
Q

Common side effects of both typical and atypical antipsychotics

A

Anti-muscarinic: dry mouth, blurred vision, urinary retention, constipation
Sedation
Weight gain
Raised prolactin (less likely in atypical antipsychotics)
Impaired glucose tolerance
Neuroleptic malignant syndrome: pyrexia, muscle stiffness
Reduced seizure thresholds

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5
Q

Antipsychotics: monitoring bloods

A

FBC, UEs, LFTs at start of therapy and annually

Lipids, weight at start of therapy, 3 months, annually

Fasted blood glucose, prolactin at start of therapy at 6 months, annually

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6
Q

Other monitoring: antipsychotics

A

Just remember cardio stuff
BP
ECG
Cardiovascular risk assessment (annually)

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7
Q

Benzodiazepines act on which channels

A

Enhance GABA by increasing the frequency of chloride channels

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8
Q

What length of time should benzodiazepines be prescribed for

A

2-4 weeks

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9
Q

If patients are withdrawn too quickly from BZPs, what may occur:

A

BZP withdrawal syndrome
Insomnia
irritability
anxiety
tremor
loss of appetite
perceptual disturbances

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10
Q

2 non -drug contraindications of BREAST FEEDING

A

Galactosaemia
Viral infections

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11
Q

Antibiotic contraindications during breast feeding (not necessarily pregnancy)

A

Ciprofloxacin, tetracycline, chloramphenicol, sulphonamides

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12
Q

Psychiatric drugs which are contraindicated in breast feeding

A

Lithium
Benzodiazpines

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13
Q

Other drugs which are contraindicated in breast feeding

A

Aspirin
Carbimazole
Methotrexate
Methotrexate
Sulfonylureas
Cytotoxic drugs
Amiodarone

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14
Q

UKMEC 4 contraindications of COCP

A

> 35 years-old and more than 15 cigarettes/ day
Migraine with aura
History of VTE or ischaemic heart disease
Breast feeding < 6 weeks PP
Uncontrolled hyppertension
Current breast cancer
POSITIVE ANTI-PHOSPHOLIPID ANTIBODIES

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15
Q

UKMEC 3 contraindications

A

> 35 <15 cigarettes/day
BMI > 35
Family history of thromboembolic disease
Controlled hypertension
Immobility: wheel chair use
Carrier of known gene mutations (BRCA1/ BRCA2
Current gall bladder disease

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16
Q

Tx. FAECAL impaction in children

A

MOVICOL paediatric Plain
2) MOVICAL PLUS STIMULANT (if no response in 2 weeks)
3) Substitute a stimulant laxative singly or in combination w/ osmotic laxative such as lactulose if Movicol not tolerated

Maintenance therapy is a similar regime

17
Q

COCP MoA

A

Inhibits ovulation

18
Q

PoP MoA

A

Thickens cervical mucus
Desogestrel inhibits ovulation and thickens cervical mucus

19
Q

Depot (medroxyprogesterone acetate) MoA

A

Inhibits ovulation and thickens cervical mucus

20
Q

Implant MoA:

A

Inhibits ovulation and thickens cervical mucus

21
Q

Copper coil MoA

A

Decreases sperm motility and survival -> inhibits IMPLANTATION

22
Q

IUS (mirena coil) MoA

A

Prevents endometrial proliferation and thickens cervical mucus

23
Q

All children with croup should receive:

A

DEXAMETHASONE (0.15mg/kg)

24
Q

GAD tx.

A

1) Education and active monitoring
2) Self help
3) CBT +/- drug treatment

25
Q

Drug treatment for GAD

A

First line is SERTRALINE
if ineffective offer an alternative SSRI/SNRI
If neither can be tolerated consider PREGABALIN

26
Q

UKMEC4 for Nexplanon:

A

Current breast cancer

27
Q

When can IUS and IUD be relied upon respectively:

A

IUS after 7 days (uses hormones)
IUD immediately as more of a physical blockade

28
Q

Lithium adverse effects: (LITHIVM

A

Leucocytosis
Inspipidus (diabetes)
Tremor/teratogenicity
Hypothyroidism
Increased weight
V - vomitting
Miscellaneous - ECG changes T wave flattening/inversion, acne, hyper calcaemia

29
Q

Adverse effects of RETINOIDS (isotretinoin)

A

Teratogenicity
Dry skin, eyes, lips/mouth
Low MOOD
Raised triglycerides
Photosensitivity
Hair thinning
Nose bleeds
Intracranial hypertension

30
Q

Rosacea mx.

A

Predominant flushing/erythema -> Brimonidine gel as required

Mild/moderate: topical IVERMECTIN
alt. topical metronidazole or topical azaelic acid

Moderate to severe papules and pustules
TOPICAL IVERMECTIN w/ oral DOXYCYCLINE

31
Q

SSRI most useful in pts. w/ previous MI

A

SERTRALINE

32
Q

SSRI side effects

A

GI symptoms = most common side effect
Increased of GI bleeding -> PPI should be offered if pt. also taking an NSAID

33
Q

SSRI which prolongs the QT interval

A

CITALOPRAM
40 mg is maximum daily dose for adults
20 mg for elderly (plus 65 years)
20 mg for hepatic impairment

34
Q

Should SSRIs be given with WARFARIN/HEPARIN

A

NO, instead use MIRTAZAPINE

35
Q

Other interactions of SSRIs

A

Triptans (serotonin syndrome)
MAOIs (serotonin syndrome)

36
Q

Tricyclic antidepressants adverse effects

A

Drowsiness
Dry mouth
Blurred vision
Constipation
Urinary retention
Lengthening of QT interval

37
Q

Mx URGE incontinence

A

1) Bladder retraining (6weeks)
2) Anti-muscarinics (OXYBUTYNIN, Tolteridone, Darifenancin
3) Mirabegron may be used if there is concern about anticholinergic side effects in frail elderly patients

38
Q

Mx. STRESS INCONTINENCE

A

1) Pelvic floor muscle training
2) surgical procedures - retropubic mid-urethral tape procedures
3) Duloxetine if women DECLINE surgical intervention

PSA (10 decks)

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