Acute care
What is the 1st line medical management of peri-arrest bradycardia?
Atropine (500mcg IV)
How would you differentiate a basal cell carcinoma (BCC) from a squamous cell carcinoma (SCC)?
BCC = pearly papule with telangiectasia, central ulcerate 'crater'
SCC = rapidly expanding, painless, cauliflower-like, may be bleeding
Both = can be nodular, on sun-exposed sites (head, neck, dorsum of hands/arms)
What is the 1st line management trigeminal neuralgia
Carbamezepine
What are the 4 subcutaneous anticipatory care drugs in palliative care?
Midazolam - indicated in agitation
Haloperidol - indicated in sickness
Morphine - indicated for pain
Hyoscine butylbromide - indicated for secretions
What are the X-ray changes seen with osteoarthritis?
L - Loss of joint space
O - Osteophytes
S - Subchondral sclerosis
S - Subchondral cysts
What is the % area of burns required for fluid resuscitation in adults vs children.
15% - adults
10% - children
What is the 1st and 2nd line management of mild-moderate acne?
1st line: 12 week course of topical combination therapy
(adapalene + benzoyl peroxide, tretinoin + clindamycin, benzoyl peroxide + clindamycin)
2nd line: monotherapy benzoyl peroxide.
What are the characteristic CSF findings in bacterial meningitis?
Low glucose
High protein
Polymorphs
Which opioid is preferred in palliative patients with mild-moderate renal impairment?
Oxycodone preferred over morphine
A patient presents with 1 year history of memory loss. Patient forgets things like what they had for breakfast, what they did yesterday, meeting new people, and recent events. Patient has trouble recalling names of things and gets lost easily. Patient denied visual changes and loss of motor skills. Family denied mood changes.
What is the 2nd line medical management for this patient?
1st line: donepezil, galantamine, rivastigmine (acetylcolinesterase inhibitors)
2nd line: memantine (NMDA receptor antagonist)
Patient presents with T 39, HR 122, BP 78/52, O2 93%, and confusion.
Lactate >2.5 mmol/L.
What is this presentation and how do you manage this?
Septic shock.
BUFALO
(give oxygen, fluids, antibiotics)
(take bloods cultures, urine, lactate)
What is the management of moderate-severe acne?
(hint: in addition to topicals)
Add oral lymecycline OR oral doxycycline
(erythromycin if <12yo, breastfeeding, or pregnant)
What medication in Parkinson’s management worsens impulse control disorders?
Dopamine agonists (cabergoline, ropinirole, bromocriptine)
Which opioid is preferred in palliative patients with severe renal impairment?
alfentanil, buprenorphine, fentanyl
Name 5 medications that cause postural hypotension.
BLAND
Beta-blockers, L-Dopa, Antidepressants/ACEi/Anticholinergics, Nitrates, Diruetics
4 units O-ve blood.
4 units FFP.
1 unit plasma.
Elderly patient presents with itchy tense blisters around flexures. No mucosal involvement. Investigations found autoantibodies against sub-epidermal (hemidesmosomal) proteins of the skin.
What is the mainstay treatment of this condition?
Bullous pemphigoid
Oral corticosteroids
(topical corticosteroids, immunosuppressants, abx can also be used)
A patient presents with right superior quadrantopia (vision problem).
Where is the tumour?
(PITS: parietal = inferior; temporal = superior)
Name 1 type of cancer that causes osteoblastic bone metastases.
Prostate cancer
(b->p)
What are medications used in the pharmacological management of orthostatic hypotension?
Fludrocortisone
Midodrine
A patient presents after RTA. Calculate their GCS score.
Patient can moves arms to chest upon supraorbital pressure.
Patient groans but opens eyes when spoken to.
Motor - 3 (abnormal flexion to pain)
Verbal - 2 (sounds)
Eyes - 3 (opens to speech)
7yo boy presents with red rash on cheeks.
Name the causative organism of this condition.
Name the complication that causes shortened RBC lifespan for this condition.
Erythema Infectiosum caused by Parvovirus B19.
Aplastic crises cause shortened RBC lifespan.
Name 3 management steps.
Step 1 (reverse clotting abnormalities): give vitamin K + prothrombin complex concentrate.
Step 2 (lower BP, aim for 140): IV labetalol.
Step 3: decompressive hemicraniectomy.
Name 4 types of cancers causing osteolytic bone metastases.
Breast, Lung, Thyroid, Kidney cancers
(for Lunch (osteoLytic) have a BLT + Ketchup)
Name some (3) classic skin changes seen in dermatomyositis
Heliotrope rash in the periorbital region
Gottron's papules - roughened red papules over extensor surfaces of fingers
Shawl sign - macular rash over back and shoulder