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Question 1

Non-bullous impetigo treatment

Answer 1

Topical: hydrogen peroxide or fusidic acid (if around the eyes)

Question 2

Bullous impetigo (not systemically unwell)

Answer 2

Topical or oral antibacterial equally effective

oral: flucloxacillin
topical: fusidic acid

Question 3

Bullous impetigo and non-bullous impertigo in those who ARE systemically unwell

Answer 3

oral antibacterial

first line: flucloxacillin
alternative: clarithromycin, erythromycin (pregnancy)

Question 4

Human and animal bites

Answer 4

First line: Co-amoxiclav
alternative or if penicillin allergy; doxycycline + metronidazole

seek specialist advice in pregnancy

Question 5

CURB 65 definition

Answer 5

severity score for CAP

C = confusion
U = urea blood nitrogen is raised (above 7 mmol/L)
R - raised respiratory rate (30 breaths/min or more)
B - blood pressure is low (systolic less than 90, diastolic of 60 or less)
65 - 65 years old or older

Question 6

Heirachy of evidence

Answer 6

1) Systematic reviews
2) Randomised control trials
3) cohort studies
4) case controlled studies
5) case studies, case reports
6) editorials, expers opinion

Question 7

INR of 5-8 and minor bleeding

Answer 7

Omit warfarin
Give IV pytomenediaone
Repeat if INR is still high after 24 hours
restart when INR is <5.0

Question 8

INR greater than 8 and minor bleeding

Answer 8

omit warfarin
give IV pytomediaone
repeat if INR still high after 24 hours
restart warfarin when INR is <5.0

Question 9

INR 5-8 and no bleeding

Answer 9

withod 1-2 doses, REDUCE maintenance dose, measure INR after 2-3 days

Question 10

INR > 8 and no bleeding

Answer 10

omit warfarin
give oral pytomenidianoe
repeat dose if INR is still high after 24 hours
restart when INR is < 5.0

Question 11

Lithium toxicity treatment

Answer 11

volume resucitation with normal saline
severe toxcity - haemodialysis
sodium bicarbonate (limited evidence to support use)

Question 12

Digoxin toxicity treatment

Answer 12

DigiFab

Question 13

Iron toxicity treatment

Answer 13

Desoferroxiame (chelating agent)

Question 14

cyanide poisoning

Answer 14

Hydroxycobolamin

Question 15

Paracetamol poisoning

Answer 15

N-acetylcysteine
activated charcoal (if ingested less than 1 hour ago)

Question 16

Heparin toxicity

Answer 16

protamine sulfate

Question 17

Warfarin toxicity

Answer 17

Vitamin K
Prothrombin complex

Question 18

Benzodiazipines toxicity

Answer 18

Flumanezil

Question 19

salicylate toxicity

Answer 19

urinary alkalization with IV bicarbonate
haemodialysis

Question 20

TCA toxicity

Answer 20

IV bicarbonate

Question 21

Beta blockers toxicity

Answer 21

bradycardic - atropine
resistant cases - glucagon

Question 22

opioid/opiates toxicity

Answer 22

Naloxone

Question 23

Ethylene glycol and methanol toxicity

Answer 23

ethanol
fomepizole (first line)
refractory cases - haemodialysis

Question 24

Potent corticosteroids

Answer 24

Beclometasone dipropionate (0025%)
Betnovate (betamethasone valerate 0.1%)
Elocon
Synalar

Question 25

Mild corticosteroids

Answer 25

Hydrocortisone 0.1- 2.5 % Synalar 1 in 10 Dioderm

Question 26

Very potent corticosteroids

Answer 26

Dermovate Nerison Forte

Question 27

Moderate corticosteroids

Answer 27

Betnovate-RD (betamathasone valerate 0.025%) Eumovate Synalar 1 in 4

Question 28

Very potent + antimicrobials

Answer 28

clobetasol + neomycin + nystatin

Question 29

why antimicrobials with steroids

Answer 29

useful in inflammatory skin conditions associated with bacterial or fungal infectiosn e.g. infected eczema

Question 30

mild + antimicrobials

Answer 30

Canesten - HC Daktacort Fucidin H

Question 31

moderate + antimicrobial

Answer 31

Trimovate

Question 32

benefit of urea with corticosteroid

Answer 32

increases penetration of steroid

Question 33

benefit of salicylic acid with steroid

Answer 33

increased setroid penetration and absorbption (e.g. diprosalic, a potent steroid with salicyclic acid)

Question 34

potent + antimicrobials

Answer 34

Betamethasone + neomycin Betamethasone + clioquinol Fucibet Synalar C Synalar N Lotriderm