Term
PTU: dose 200-400mg for 3 weeks
Maintenance: 25-300mg
Carbimazole: 20-40mg for 3 weeks
maintenance: 5-40mg for 12-18 months |
|
Definition
Use: hyperthyroidism
S/E: pruritic, rash, neutropenia, hepatitis
IA (interactions): induces warfarin and theophylline
MON: T4 and TSH 6 weeks, HTN, HR, insomnia, weight. |
|
|
Term
Thyroxine (T4): 50-100mcg. increase 50 every 3-4 weeks. elderly 25-50mcg
Liothyronine (T3): IV 5-10mcg in coma |
|
Definition
Use: hypothyroidism
S/E: decreased bone density and increase heart disease
IA (interactions): Iron decrease its abs
MON: T4 and TSH, HTN, HR, weight. |
|
|
Term
| Carbamazepine: 100mg bd (enzyme inducer) |
|
Definition
Use: epilepsy, nerve pain
S/E: ataxia, SJS, osteoporosis, dizziness
IA: Verapamil, diltiazem and clarithromycin increases cmz conc. Phenytoin and valproate decreases conc of cmz. CMZ decreases conc of COC, warfarin.
MON: epilepsy and pain |
|
|
Term
| Phenytoin: 200-500mg daily |
|
Definition
Use: 2nd line epilepsy
S/E: SJS, ataxia, dizziness, osteoporosis, gingival hyperplasia
IA: Amiodarine increases phenytoin conc. decreases warfarin and COC. |
|
|
Term
| Valproate: 300mg bd max 2.5g |
|
Definition
use: epilepsy
S/E: confusion, tremor, osteoporosis and weight gain
IA: CMZ and phenytoin |
|
|
Term
| Benzo and phenobarbitone can be used for? |
|
Definition
| Epilespy, but sedation and tolerance can occur |
|
|
Term
|
Definition
use: absence
S/E: GI intolerance, weight loss, ataxia, rash |
|
|
Term
|
Definition
gabapentin
Lamotrigine: valproate and phenytoin increase it. CMZ and COC, decrease it
levetiracetam. initial 25mg every 2nd day.
ocxcarbazepine
pregabalin
tiagabine
topiramate
Vigabatrin (lst resort) visual field defect |
|
|
Term
Iron: 100-200mg
pregnant 60-120mg |
|
Definition
Use: IDA
MON: ferritin, transferrin, Hb, MCY, PCV |
|
|
Term
B12: oral 100mcg bd.
IM: trans and cyano 1000mcg for 1-2 weeks |
|
Definition
Use: low B12 (macrocytic anaemia)
MON: MCV, Hb, serum B12 |
|
|
Term
Folate: oral: 5 od for 4 months
pregnant: 5mg before, 500mcg in the 1st 12 weeks. Methotrexate 5mg on different day |
|
Definition
Use: pernicious anaemia
MON: folate, MCV, Hb |
|
|
Term
Paroxetine: (SSRI)20-40mg
Venlafaxine: (SNRI) 150-300mg |
|
Definition
1st line for anxiety
2nd line |
|
|
Term
SSRI in order
Citalopram: 20-40
escitalopram: 10-20
fluoxetine: 20-40
Fluvoxamine: 100-200
paroxetine: 20-40
sertraline: 50-100 |
|
Definition
USE: depression
S/E: agitation, nausea, anxiety, headache, bleeding, sexual disfunction
IA: pethidine, tramadol, MDMA, dextromethorphan, SJW can give serotonin syndrome. |
|
|
Term
SNRI: desvenlafaxine: 50-150
Duloxetine: 30-60
venlafaxine: 150-300 |
|
Definition
Use: depression
S/E: agitation HTN, increase lipid and sexual dysfunction. can also give serotonin syndrome. |
|
|
Term
|
Definition
use: depression
S/E: sedation, increase weight and appetite |
|
|
Term
|
Definition
Use: depression
S/E: anticholingeric |
|
|
Term
|
Definition
Use: depression
S/E: insomnia, diarrhoea
IA: dopamine and adrenaline |
|
|
Term
|
Definition
Use: depression
S/E: dry mouth, cardiotoxic, hypotension |
|
|
Term
| Agomelatine: 25-50 at night |
|
Definition
Use: depression
S/E: increase liver enzymes, nausea, dizziness
IA: CYP1A2 inhibitors |
|
|
Term
| Irreversible MAOI: phenelzine and tranylcyramine |
|
Definition
Use: depression
S/E: anticholingeric
IA: SSRI, pseudoephridine, insulin and tyramine foods |
|
|
Term
|
Definition
| Use: antidepressants, antipsychotics, HRT, bisphosphonates and supplements |
|
|
Term
|
Definition
Fluoxetine 20-60mg
Topiramate 250mg |
|
|
Term
Lithium (BPAD)
acute: 750-1500mg initially |
|
Definition
TR: 0.5-1.2mmol/L
S/E: ataxia, tremor, NVD, HTN, hypothyroidism, coma and seizures
IA: SSRI, ACEi, loop diuretics, NSAID, CMZ (neurotoxicity), Thiazide, Ural decrease lithium
MON: TR levels, U&E, TFT,HbA1c, HR, ECG, WCC, TF |
|
|
Term
| Valproate (BPAD) 2nd line, 200-400 bd, max 3g |
|
Definition
S/E: anorexia, NVD, hair loss, weight gain, increased LFT
NOT FOR HEPATIC IMPAIRED
MON: LFT, WCC, weight |
|
|
Term
|
Definition
NSAIDs
Corticosteroids: 5-10mg
sulfasalazine: 500mg max 1.5g, EC
hydroxychloroquine: less effective
methotrexate |
|
|
Term
| Methotrexate: RA, 5-25mg once a week |
|
Definition
use folic acid 5mg once a week on a different day from methotrexate
S/E: myelosuppression, GI toxicity, pulmonary, heptatoxicity and nephrotoxicity
IA: Ciprofloxacin, doxycycline, omeprazole increase it. NSAID renal. Trimethoprim plus sulfamethoxzole increase toxicity and decrease folate
IA: FBP, U&E, LFT, CXR (chest x-ray) |
|
|
Term
| RA if not suitable for methotrexate? |
|
Definition
Leftunomide 10-20 for 4 weeks
S/E: GI, alopecia, HTN, pneumonia
MON: FBP, U&E, BP, LFT |
|
|
Term
|
Definition
adalimumab
certolizumab
etanercept
golimumab
infliximab
MON: FBP, Cr, LFT |
|
|
Term
| RA others (reserved or combo with methotrexate) |
|
Definition
rituximab
abatacept
anakinra
tocilizumab |
|
|
Term
|
Definition
Paracetamol
Topical or oral NSAIDs
steroids
opioids
Glucosamine |
|
|
Term
|
Definition
Indomethacin with paracetamol 50mg tds
25mg bd for prophylaxis
corticosteroids (prednisolone 15-30mg) if NSAIDs don't work |
|
|
Term
| Colchicine 1mg initially then 1 hour, repeat in 3 days |
|
Definition
| for gout (before allopurinol) |
|
|
Term
|
Definition
allopurinol 100-300mg
S/E: gout attack, rash, fever, hepatotoxicity, not for renal impairment (nephrotoxic)
IA: amoxicillin, ampicillin (rash), azathioprine, mercaptopurine (myelosuppression)
MON: renal function |
|
|
Term
|
Definition
probenecid 500mg-2g daily
S/E: rash, flushing, sore gums, kidney stones
IA: aspirin (reduce probenecid effect) |
|
|
Term
Typical antipsychotics (negative symptoms respond poorly)
TAP
smoking decreases levels
depot more epse |
|
Definition
Haloperidol
Pimozide
chlorpromazine
pericyazine
trifluoperazine |
|
|
Term
Atypical antipsychotics (AAP)
Smoking decreases levels
depot more epse |
|
Definition
Amisulpride: rarely used
Aripiprazole: not that good
Clozapine: 2nd line
Olanzapine: 1st line
Quetiapine: 1st line but expensive
Paliperidone:
Risperidone: 1st line
Ziprasidole: 1st line
Sertindole: 2nd |
|
|
Term
Haloperidol 1-7.5mg or depot 12.5-75mg
Pimozide |
|
Definition
S/E: less anticholingeric, more EPSE, less sedation, less orthostatic HTN
IA: depressants, CYP450 drugs |
|
|
Term
Amisulpride (AAP) 400-1000 acute
100-300 for negative S/E |
|
Definition
| S/E: not many but hyperprolactineamia |
|
|
Term
|
Definition
| S/E: weight gain, not many S/E but not that good |
|
|
Term
| Olanzapine (AAP) 5-30 or depot 210-405 |
|
Definition
S/E: increased metabolic effect, sedation, anticholingeric
IA: CMZ, fluvoxamine
MON: FBC, ECG, BP< troponin in 18 weeks |
|
|
Term
| Clozapine: AAP 200-600 (good for negative) |
|
Definition
S/E: increased metabolic, sedation, hypersalivation
IA: SSRI, CMZ
MON: FBC, ECG, BP and troponin |
|
|
Term
|
Definition
S/E: hyperglycaemia
IA: CMZ, phenytoin |
|
|
Term
| Paliperidone: AAP 3-12 or depot 150-250 |
|
Definition
| S/E: CMZ, fluoxetine and paroxetine |
|
|
Term
| Risperidone: 2-6 or depot 25-50 |
|
Definition
S/E: weight gain, sedation initially
IA: CMZ, fluoxetine and paroxetine |
|
|
Term
| Ziprasidole: 80-160 but expensive |
|
Definition
S/E QT prologation
IA: CMZ |
|
|
Term
|
Definition
S/E QT prolongation
IA: fluoxetine, paroxetine |
|
|
Term
|
Definition
Smoker >35
CVD risk
History of VTE
migraine with aura with 5 years
breast cancer
lupus
hepatitis
cancer |
|
|
Term
|
Definition
| S/E: nausea take with food, acne, weight gain, decreased libido, headaches, breakthrough bleeds, chloasma |
|
|
Term
|
Definition
CMZ, phenytoin, SJW, modafinal, rifamycin, lamotrigine, topiramate all decrease COC.
use: IUD or DMPA instead or increase dose of COC |
|
|
Term
|
Definition
| for older women, because it takes 9 months to return to normal cycle |
|
|
Term
| how long do implants last? |
|
Definition
|
|
Term
|
Definition
| can cause miscarriage, but good for heavy bleeding |
|
|
Term
|
Definition
IUD
progesterone only
not COC |
|
|
Term
Diabetes insipidus (water diabetes)
Decrease ADH hypernatraemia |
|
Definition
Central/Neurogenic: lack of ADH production, storage or release
Nephrogenic: failure of kidneys to respond to ADH
genetic or via meds |
|
|
Term
| treatment of diabetes insipidus (decrease ADH) |
|
Definition
desmopression 10-40mcg nasal or 100-200 orally tid (ADH)
Vasopression 5-10units tid (ADH)
Stimulate release: carbazepine, chlorproamide
Nephrogenic: hydrochlorothiazide with amiloride
MON: dehydration, serum Na, urine osmolality |
|
|
Term
|
Definition
|
|
Term
| differential diagnosis of hyponatraemia |
|
Definition
Hypovolaemic >20/<10mmol/L use: isotonic saline
Euvolaemic: >20mmol/L use: fluid restriction, hypertonic saline
Hypervolaemic: >20/<10mmol/L use: Na and water restriction, no saline |
|
|
Term
|
Definition
1st: ID cause
2nd fluid restriction 500-800ml and gradual in serum Na
3rd: if severe hypertonic saline 1.8-5% with Frusemide
4th: if serum Na not normal: demeclocycline 600-900mg ddd and MON: nephrogenic DI |
|
|
Term
|
Definition
Somatropin: children 4.5-7mg/m2 week
Adult: 150-300mg/day
S/E: local reaction at site, peripheral oedema, intracranial HT
MON: GH levels, BGL, LFT |
|
|
Term
| excessive GH (Acromegaly) Tx: |
|
Definition
Surgery
D agonist Bromocriptine 1.25 to 30mg ddd
S/E: NV, cramps, GI, haemorrhage
MON: GH, BGL, LFT
Carbegoline: 0.5-2mg
S/E: leg cramps but less gi effects |
|
|
Term
|
Definition
overproduction of cortisol or prolonged glucocorticoid medication.
S&S: weight gain
moon face
impaired glucose tolerance
acne
muscle weakness
skin thinning
depression
osteoporosis |
|
|
Term
|
Definition
review meds
surgery
radiotherapy
1st: surgery plus glucocoericoid plus mineralocorticoid supps (6-18 months)
2nd: radiation, but can cause deficiency in other hormones
as adjunct: aminoglutethimide 0.75-2g ddd or ketoconazole 600-1200mg/day
MON: signs of med toxicity, other conditions from this (diabetes, osteoporosis, peptic ulcer)
free cortisol post surgery |
|
|
Term
| hyperaldosteronism (excessive Aldosterone secretion for adrenal gland) |
|
Definition
Conn syndrome: s&s: sodium retention, K wasting
elevated BP |
|
|
Term
|
Definition
Primary: surgery and spironolactone 50-200mg d
secondary: tx depend on
MON: BP
serum Na, K
plasma renin, alkalosis signs,
aldosterone |
|
|
Term
|
Definition
| lack of GC (cortisol)and MC Aldosterone)with elevated ACTH (loss of negative feedback) common in 30-60 |
|
|
Term
|
Definition
NVD,
fatigue,
weight loss,
loss of appetite,
low BP,
salt craving,
depression,
dehydration,
hyperpigmentation
hypoglycaemia |
|
|
Term
|
Definition
replacement therapy
GC: dexamethasone 0.5mg or
prednisolone 5mg d plus
MC: fludrocortisone 50-100mcg od or bd
MON: GI symptoms
HT, Hypokalaemia
insomnia, diabetes
weight |
|
|
Term
| averting addisonian crisis |
|
Definition
Is an emergency, when infection or surgery, can cause death
double cortisone dosage for 2-3 days in case of:
infection
physical stress
trauma
surgery
adrenal insufficiency
Management if occurs: IV hydrocortisone 100mg stat q6h for 24 hours plus 4%glucose on 0.18% saline and tx cause |
|
|
Term
|
Definition
| mupirocin 2% q8h for 7 days |
|
|
Term
| widespread impetigo & ecthyma Tx: |
|
Definition
Di/flucloxacillin: 500mg q6h 10days or
cephalexin: 1g bd for 10 days or
roxithromycin: 300mg for 10 days |
|
|
Term
| Follicultis: sml spots red like pimples of hair follicle. |
|
Definition
Mupirocin or rifampicin plus
Di/flucloxacillin or sodium fusidate |
|
|
Term
|
Definition
| Drain plus if bad di/flucloxacillin 500mg q6h for 5 days |
|
|
Term
| Cellulitis and Erysipelas Tx: |
|
Definition
di/flucloxacillin 500mg q6h 10 days or if severe
Phenoxymethylpenicillin or cephalexin IV |
|
|
Term
| Severe gram -ve skin infections |
|
Definition
|
|
Term
| Diabetic osteomyelitis or foot ulcers Tx: |
|
Definition
Amoxycillin CA 875/125 bd 5 days mixed infections
cephalexin 500mg for 5 days for mixed infection
Metronidazole: 400 bd 5 days for anaerobic infections |
|
|
Term
|
Definition
acyclovir 5% or
acyclovir oral 400mg 5 times for 5 days or
famciclovir or valciclovir 1800mg stat |
|
|
Term
|
Definition
famciclovir 250mg tds 7 days or
valaciclovir 1g tds 7 days
acyclovir 800mg 5 days |
|
|
Term
|
Definition
topical imidazoles (nystatin)
fluconazole or itraconazole 50mg for 2 weeks |
|
|
Term
|
Definition
topical imidazoles
griseofulvin 500-1000mg 4-52 weeks
terbinafine 250mg 2-12 weeks
ketoconazole: 200-400mg 4-52 weeks |
|
|
Term
|
Definition
econazole 1% wash or
ketoconazole 400mg once. |
|
|
Term
| severe cutaneous drug eruptions for: like SJS |
|
Definition
allopurinol
antiepileptics
NSAIDs
Sulfonamides
Penicillin
Aniretroviral
REMOVE CAUSATIVE DRUG ASAP |
|
|
Term
|
Definition
chlamydia trachomatis
S&S: dysuria
vagina discharge
ab pain
pain in penis
Complications: infertility
etopic pregnancy
prostatitis |
|
|
Term
|
Definition
azithromycin 1g stat
doxycycline 100mg bd 7 days |
|
|
Term
|
Definition
Neisseria gonorrhoeae
S&S: dysuria
vagina discharge
ab pain
pain in penis
Complications: infertility
PID (pelvic inflammatory disease)
joint and skin infections |
|
|
Term
|
Definition
| ceftriaxone 250mg IM once |
|
|
Term
|
Definition
S&S: vagina discharge
lower ab pain
dysuria
spotting
Complications: tubal infertility
etopic pregnancy |
|
|
Term
|
Definition
azithromycin 1g once plus
ceftriaxone 500mg IM once plus
metronidazole 400mg bd 14 days plus
doxycycline 100 bd 14 days |
|
|
Term
|
Definition
treponema pallidum
3 stages, last stage effects the brain and may be to late |
|
|
Term
|
Definition
procaine pg 1.5mg 10 days or
doxycycline 100 bd 14 days |
|
|
Term
|
Definition
trichomonas vaginalis
S&S: women discharge yellow or green
Men asymptomatic |
|
|
Term
|
Definition
| metronidazole 2g oral once |
|
|
Term
|
Definition
gardnerella vaginalis
S&S: thin grey discharge with fish odour |
|
|
Term
|
Definition
| metronidazole gel or oral 400mg bd for 7 days |
|
|
Term
|
Definition
C albicans
S&S: cottage cheese like discharge |
|
|
Term
| vulvovaginal candidiasis tx: |
|
Definition
imidazole topical 6 days or
fluconazole 150mg once or
boric acid 400mg bd for 7 days |
|
|
Term
|
Definition
Klebsiella granulomatis
S&S: subcutaneous nodules
painless ulcers
aboriginals |
|
|
Term
|
Definition
| azithromycin 1g weekly for 4 weeks |
|
|
Term
|
Definition
| oral faecal route (no cure for hep A) |
|
|
Term
|
Definition
injection or sex
vaccine for druggies and high risk health care workers (no cure) |
|
|
Term
|
Definition
| chronic condition, by sharing needles or trauma causing bleeding during sex |
|
|
Term
|
Definition
| via sex co infection with Hep B |
|
|
Term
|
Definition
oral faecal,
acute and self limiting |
|
|
Term
|
Definition
|
|
Term
|
Definition
<350 CD4+T cells
350-500 if Tx or deferred, mon CD4
>500 tx or defer depend on patient |
|
|
Term
|
Definition
Highly active antiretroviral therapy
combo: 2 NRTI/NtRTI + 1 NNRTI or 1 PI (boosted with ritonavir)
eg. tenofovir+emtricitabine+efavirenz or Tenofovir+emtricitabine+atazanavir with ritonavir |
|
|
Term
|
Definition
abacavir (SJS)
didanosine (peripheral neuropathy)
emtricitabine
lamivudine
stavudine (insulin resist, peripheral neuropathy, dyslipidaemia, lipodystrophy, osteonecrosis)
Zidovudine (lipodystrophy, osteonecrosis)
NtRTI: tenofovir |
|
|
Term
|
Definition
Efavirenz (SJS)
Etavirine
Nevirapine (hepatotoxicity, SJS)
Rilpivirine |
|
|
Term
|
Definition
all cause osteonecrosis
Atazanavir (less insulin resist or less dyslipidaemia)
darunavir
fosamprenavir (SJS)
indinavir
lopinavir with ritonavir
ritonavir
saquinavir
tipranavir |
|
|
Term
|
Definition
FI enfuvirtide
CCR5 anta maraviroc
integrase inhibitor: raltegravir |
|
|
Term
|
Definition
CD4 t-cells
viral load
allergies
drug toxicity
S/E
compliances
drug conc
psychological impact (depression) |
|
|
Term
|
Definition
S&S: shaped lunps
whitish pink to redish brown |
|
|
Term
|
Definition
crytotherapy once weekly
podophyllotoxin cream or liquid bd 3 days |
|
|
Term
|
Definition
Vaccines: cervarix HPV 16, 18 female 10-45
Gardasil HPV 16, 18, 6, 11 female 9-45, male 9-26 (better option) |
|
|
Term
|
Definition
S&S: tingling
itching
redness
ulcers |
|
|
Term
|
Definition
acyclovir 400mg tds 5-7 days
valaciclovir 500mg tds 5-7 days
famciclovir 250mg tds 5-7 days |
|
|
Term
|
Definition
S&S: hard to diagnose
red
ulcers |
|
|
Term
|
Definition
|
|
Term
|
Definition
Homo
<25
intravenous drug users
hetero with multiple partners
sex workers |
|
|
Term
|
Definition
Contact tracing
Compliance with therapy
Counselling or risk reduction
Condom promotion |
|
|
Term
|
Definition
REM and NREM
NREM has 4 stages |
|
|
Term
|
Definition
| impairment in sleep quality that is often associated with daytime consequences |
|
|
Term
|
Definition
nocturnal arousal
awakening too early
poor quality
fatigue
irritability
impaired concentration
malaise
micro sleeps |
|
|
Term
|
Definition
medical psychiatric
stress, environmental causes |
|
|
Term
|
Definition
|
|
Term
| medications that disturbs sleep? |
|
Definition
CNS stimualnts (dexies, decongestants, phentermine)
diuretics (nocturia)
beta blockers (nightmares)
SSRI (take mane)
caffeine
alcohol
NRT
sedating antihistamines (agitation) |
|
|
Term
|
Definition
rapid induction,
REM rebound
shallow sleep |
|
|
Term
|
Definition
regular time
exercise before bed
warm shower
milk
dark and quiet
BAD: naps
caffeine after lunch
illicit drugs
tobacco
pets |
|
|
Term
| long standing insomnia Tx: |
|
Definition
temazepam 5-20mg
problems: dependence, tolerance and hangover
withdrawal gradually
Zolpidem 5-12.5mg before bed can have bizarre behaviour like sleep walking, eating and driving
Zopiclone: 7.5mg at night for 4 weeks and reduce to 3.75, no alcohol
Melatonin: 2mg 1-2 hr before bed >55 yrs for 13 weeks |
|
|
Term
|
Definition
TCA,
sedating antihistamine and
valerian |
|
|
Term
| Obstructive sleep apnoea (OSA) |
|
Definition
oropharyngeal airway blocked
S&S: middle aged men
snoring
daytime drowsiness
moderate obesity
HT
effect: QOL, HT, CVD, CAD and diabetes |
|
|
Term
|
Definition
avoid alcohol and hypnoticcs
lose weight
sleep hygiene
treat nasal congestion
Modafinil 200mg daily (100mg in morning and midday) with CPAP
or
oral/dental device or surgery |
|
|
Term
| restless leg syndrome (RLS) |
|
Definition
common in RA
urge to move legs
unpleasant sensations
S&S: feels like water flowing in legs
electricity
aching
burning
Causes: idiopathic, ID, uraemia, RA |
|
|
Term
|
Definition
ropinirole 025 1-3 hrs before bed
pramipexole: 125mcg 2-3 hrs before bed
rotigotine patches: 1mg/24hrs may 3mg S/E; NV
dizziness
impulse control disorder
other gabapentin, oxycodone |
|
|
Term
| jet lag, shift work, delayed sleep phase tx: |
|
Definition
| melatonin fr jet lag and phototherapy |
|
|
Term
| use scales and assessment to assess pain level |
|
Definition
| PQRST and wong-baker face pain scale 0-10 |
|
|
Term
|
Definition
| aching and throbbing pain |
|
|
Term
|
Definition
burning
stabbing
shooting pain
tingling
numbness |
|
|
Term
|
Definition
Acute for trauma AIM cure
chronic 3-6 months AIM increase functionality |
|
|
Term
| Breakthru pain: in spite of chronic pain Tx, common in cancer |
|
Definition
immediate release 1 12th to 1 6th of SR meds, dose until pain is controlled
if not controlled after 3 doses, review
eg. morphine sr 30mg bd= 60mg, so breakthrough dose is 5-10mg every hour as required, still use normal sr dose |
|
|
Term
|
Definition
slight: paracetamol
mild: paracetamol plus NSAID
moderate: paracetamol + NSAID + codeine
Severe: paracetamol, NSAIDm potent opioid |
|
|
Term
|
Definition
for pain from inflammation and tissue damage
CI: PUD, H T, asthma, H F, renal impairment, GI effects
Risk: elderly, prior GI ulcer, on SSRI, antiplatelet or anticoagulant, prolong use |
|
|
Term
|
Definition
minimal sedation and respiratory depression
IR: 50-100 max 400mg daily
SR: 50-200 bd
lowers seizure threshold and serotonin toxicity |
|
|
Term
|
Definition
for severe pain
start with sml dose in elderly
once established IR use SR
strong opioids have no ceiling effect
S/E: N,V
constipation
drowsiness
confusion
respiratory depression
dry mouth
urinary retention |
|
|
Term
|
Definition
antiepileptics for neuro pain
antidepressants for neuro and muscle (TCA)
diazepam for smooth muscle relaxation and spasms
steroid for nerve compression
ketamine for neuro pain
calcitonin or ocreoide for burn pain
pamidronate for bone pain |
|
|
Term
|
Definition
use paracetamol with NSAIDs plus adjuvant
amitriptyline 10-25 at night
gabapentin 100-300
pregabalin 75
duloxetine 30 |
|
|
Term
|
Definition
>60
1st gen family history
Africans (POAG)
Asian (ACG)
diabetes
migraines
eye injury
smoking |
|
|
Term
|
Definition
damage to the retinal ganglion cells and the optic nerve potentially causing blindness
intraocular pressure (IOP): 10-20mm/hg Tx when >27 |
|
|
Term
|
Definition
raised IOP
visual field defect
blockade of aqueous humour outflow
peripheral visual loss
dim vision
patchy and falls |
|
|
Term
| Drug induced open angle glaucoma |
|
Definition
corticosteroid topically, systemic or inhaled like bethamethasone or dexamethasone
if can't stop monitor IOP |
|
|
Term
|
Definition
Asian high risk
narrow the angle the closer the iris to trabecular meshwork
topical anticholinergics like atropine, TCA, sedating antihistamines can worsen causing miosis |
|
|
Term
|
Definition
eye drops (increase aqueous humour flow)
Oral like acetazolamide with topical agents
laser therapy and surgery |
|
|
Term
|
Definition
pilocarpine 1-4% 3-4 times Increase flow
PG analogues: (latanoprast) at night with beta blockers like timolol
decrease flow: timolol or betaxolol 1st line S/E: bronchospasm, bradycardia, stinging, itching
2nd line acetazolamide or dorzolamide 2-3 times
alpha 2 agonist like apraclonidine |
|
|
Term
|
Definition
unilaterial pain
redness
warmth
pain in calf |
|
|
Term
|
Definition
long duration
age
overweight
tall
hypercoagulable
previous DVT
pregnancy
heart disease
cancer
on COC, hypnotics during fligh |
|
|
Term
|
Definition
drink water less alcohol
exercise
ensure comfort
prevention (stockings 20mmHg, or enoxaparin 40mg) |
|
|
Term
|
Definition
| melatonin before bedtime at destination |
|
|
Term
| Travellers diarrhoea (TD) prevention |
|
Definition
precaution with food and water
avoid tap water, milk
avoid fruit juice
avoid raw foods, buffets and street food |
|
|
Term
|
Definition
boil for 1 min
use iodine 10% 8-10 drops
chlorine 17mg 1 tab per litre |
|
|
Term
|
Definition
for immunocompromised
norfloxacin 400 on day of travel and 1-2 days when back
azithromycin if pregnant |
|
|
Term
|
Definition
norfloxacin 800 for 3 days or
azithromycin 1g once or 500 for 3 day
oral rehydration
minimise diary
loperamide in adult |
|
|
Term
|
Definition
swollen glands
rash
bleeding gums
pain behind eye recovery in several weeks
can get haemorrhagic fever |
|
|
Term
|
Definition
paracetamol with codeine
rest
fluids |
|
|
Term
|
Definition
physical barrier close and 20% DEET
Doxycycline: 100mg od for 2 days before and 4 weeks after
Mefloquine: 250mg once weekly for 2-3 weeks before and 4 weeks after
Atovaquone 250 with proguanil 100: 1 d 102 days before while there and 7 days after |
|
|
Term
|
Definition
Whiteheads: closed comedones
blackhead open |
|
|
Term
|
Definition
hyperandongenic state (puberty)
menstrual cycle (LH late phase)
medications (lithium, phenytoin, progesterone pill)
cosmetics (oils, creams)
mechanical (hat, chin straps)
environment (hot, humid) |
|
|
Term
|
Definition
multimorphous: different types
monomorphous: usually drug induced |
|
|
Term
|
Definition
benzyl peroxide 2.5-10%
retiniods (adapalene)
azeliac acid
antibiotic (erythromycin or clindamycin gel)
sal acid or suphur peroxide |
|
|
Term
|
Definition
mino or doxycycline, erythromycin
tretinoins (isotretinoin)
anti-androgenic (gestodene, cyproterone) |
|
|
Term
|
Definition
antibiotic or new OCP plus benzyl acid 5%
doxy or mino 50-100mg, or erythromycin 250-500mg for 3-6 months |
|
|
Term
|
Definition
isotretinoin 20mg for 6-9 months (not for pregnant or breast feeding)
S/E: tertatogenicity
dry skin
redness
peeling
photosensitivity
dry mouth, nose, eyes
high TG and LDL low HDL
increase liver enzymes and depression |
|
|
Term
|
Definition
| a chronic, common inflammatory and hyperplastic disease characterised by erythema and scaling |
|
|
Term
|
Definition
1-3%
at 16-22 years considered more severe
close family have a higher chance |
|
|
Term
|
Definition
t cells mediated auto immune disorder
viral antigen with t cells undergo clonal expansion
these activate and produce cytokines (TNF-a) with changes in keratocytes |
|
|
Term
|
Definition
infection
trauma on skin
stress
cold weather
sumlight
hormones
alcohol, smoking, medications
Drugs: ACEi, CCB. B-blockers, lithium, NSAIDs, antimalarials |
|
|
Term
|
Definition
rich full red lesions
sharp demarcated plaques
flat and thick various sizes
scaling silvering and itch |
|
|
Term
|
Definition
Emollients (glycerol in sorbolene, urea, oatmeal)
Keratolytics: 2-10% sal acid in sorbolene
Corticos: mild: hydrocortisone 0.5-1% moderate: betamethasone 0.05% potent: betamethasone 1%, mometasone 0.1% very potent: betamethasone dipropionate in optimised vehicle (s/e: loss of collagen, easy bruising, skin thinning, cushings syndrome) |
|
|
Term
| other topical psoriasis tx: |
|
Definition
calcipotriol: for 6 weeks MON; calcium 0..5% bd, in combo with cortico for 4 weeks
Dithranol: apply 15-30 mins and wash off
Tazarotene: (retinoid)
Phototherpay: UVA, UVB narrow and broad |
|
|
Term
|
Definition
methotrexate: 7.5-15mg a week with folate sup
Cyclospron: 1.5mg/kg S/E: uncontrollable HT and nephrotoxicity
Acitretin: (retinoid) 25-50mg with phototherapy
Biologics: (infliximab, adalimumab, etanercept) expensive and reserved MON LFT, FBC, TB |
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