treatment- phenoxymethylpenicillin or if allergic, clarithromycin usually viral but treated with antibiotics if bacterial - paracetamol/ibuprofen for pain - cold drinks/ice cream - salt water gargles - keep hydrated red flags- difficulty breathing/swallowing/persistent fever

treatment- calamine, paracetamol, antihistamine - avoid itching - calamine can be cooled - no ibuprofen - wash bedding

OSCE Flashcards by Sophie McAteer

Nail infection- Onychomycosis
CAUSES AND TREATMENT

caused by dermatophyte or candida, warm damp environments

treatment- antifungal nail lacquer – Amorolfine (must be applied for a long time, takes months to treat)

keep nails dry and cut short; apply lacquer to clean filed nails 1-2 per week for 6 months (toenails 9-12 months)

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nail infection symptoms

symptoms are brittle, discoloured, thickened nails

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Pharyngitis

treatment- phenoxymethylpenicillin or if allergic, clarithromycin usually viral but treated with antibiotics if bacterial

paracetamol/ibuprofen for pain
cold drinks/ice cream
salt water gargles
keep hydrated

red flags- difficulty breathing/swallowing/persistent fever

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Otitis media

treatment- phenoxymethylpenicillin or if allergic, clarithromycin
- paracetamol/ibuprofen for pain
- finish antibiotic course
- fluids and rest

red flags- persistent fever, discharge

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UTI

treatment - trimethoprim or nitrofurantoin
- keep hydrated
- nitrofurantoin may turn urine brown
- wipe front to back,
- urinate when needed

red flags- persistent fever, worsening pain/moving to kidneys

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C diff

treatment- oral vancomycin
- complete antibiotic course
- hand hygiene

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Herpes simplex cold sore

treatment- aciclovir topically; 5 times daily for 5 days
- don’t touch lesions except for application
- don’t share cloths/towels
- wash hands after application
- avoid kissing

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Cellulitis/erysipelas

treatment- flucloxacillin
- finish antibiotic course
-elevate affected limb

red flags- rapid spread, systemic illness, fever

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Chickenpox

treatment- calamine, paracetamol, antihistamine

avoid itching
calamine can be cooled
no ibuprofen
wash bedding

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Athlete’s foot

treatment- miconozole cream (daktarin)
- keep feet dry and clean
- change socks daily
- dont share towels
- continue miconazole 7 days after healing

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Ringworm

treatment- clotrimazole or miconazole 2% cream
- continue 10 days after healing
- don’t share towels/bedsheets

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Vaginal thrush

treatments- clotrimazole pessary, fluconazole capsule, clotrimazole cream (choose one)
- avoid sex until healed
- hygiene
- avoid tight fitting underwear
- avoid scented products

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Scabies

treatment
- permethrin cream or ivermectin oral
- apply to whole body and wash off after 8-10 hours
- reapply if hands washed
- 2 applications 7 days apart

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Impetigo

treatment
- fusidic acid cream
- apply 3 times daily 5-7 days
- wash bedding
- don’t share towels
- avoid touching (contagious)

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Acne

treatment
- benzoyl peroxide
- may need antibiotics/retinoids if severe
- caused by sebum overproduction
- apply once/twice daily
- avoid UV
- may bleach fabrics
- good hygiene and diet

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Folliculitis

treatment- usually self-resolving
- antibacterial soap
- avoid shaving/irritation

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Oral thrush

treatment
- miconazole oral gel

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Peptic ulcer disease

treatment
- PPIs first line
- H2 antagonists
- misoprostol if NSAID induced

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H pylori ulcer (no penicillin allergy)

treatment
- PPI, amoxicillin, clarithromycin or metronidazole

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H pylori ulcer (penicillin allergy)

treatment
- PPI, metronidazole and clarithromycin

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GORD

treatment
- antacids, alginates, PPIs

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IBD (ulcerative colitis/Crohn’s)

treatment
- aminosalicylates (mesalazine), corticosteroids (prednisolone), immunosuppressants

steroids used for flares not maintenance

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Diarrhoea

treatment
- antimotility drugs (diphenoxylate, racecadotril, loperamide), codeine phosphate

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Constipation

treatment- laxatives, linaclotide, lubiprostone

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Type 2 diabetes

treatment- first line - metformin, SGLT2 inhibitors (empagliflozin) if those not tolerated or not working well - sulphonylureas, GLP-1, DPP-4 inhibitors

Primary hypothyroidism

treatment- levothyroxine

Secondary hypothyroidism

treatment- levothyroxine

Hyperthyroidism

treatment- surgery, radioactive iodine, carbimazole

Cushing’s syndrome

treatment - surgery, mifepristone

Antihypertensives

treatment - ABCD rule -- AB for under 55, CD for over 55 or black - ACE inhibitors, ARBs (ramipril, losartan) - beta blockers (bisoprolol) - CCBs (amlodipine) - diuretics (indapamide) - aldosterone antagonists (spironolactone)

Hypertension (secondary prevention)

treatment - aspirin, statins

Hypertension (high risk)

treatment - statins if QRISK >10

Stable angina

treatment- aspirin/statin - beta blocker or CCB - GTN spray

NSTEMI

treatment - MONA (morphine, oxygen, nitrates, aspirin) - ticagrelor - metoclopramide - fondaparinux

STEMI

treatment - PCI with ticagrelor/clopidogrel - thrombolysis + LMWH

Post-MI secondary prevention

treatment - aspirin lifelong - ticagrelor/clopidogrel (1 year) - beta blocker - ACE inhibitor - statin

Atherosclerosis

treatment - antiplatelets (aspirin, clopidogrel, ticagrelor)

Stroke (acute)

treatment - aspirin 300 mg daily until 2 weeks

Heart failure

treatment - ACE inhibitors - beta blockers - aldosterone antagonists - diuretics - vasodilators

AF stroke prevention

treatment - warfarin or DOAC - factor Xa inhibitors

AF rate control

treatment - beta blockers - rate-limiting CCB - digoxin

Rheumatoid arthritis

treatment - DMARDs - anti-inflammatories - anti-TNF agents

Lupus

treatment - DMARDs - corticosteroids - cytotoxic drugs - IV immunoglobulin

MS attack

treatment - IV corticosteroids

Relapsing MS

treatment - interferon beta - glatiramer acetate

Atopic dermatitis

treatment - topical steroids - tacrolimus

Lice

treatment - dimeticone

warts

caused by HPV virus usually no treatment required unless causing pain if so then salicylic acid

what are risk factors for peptic ulcer

- NSAID use - smoking - stress - H. pylori

how to tell gastric vs duodenal ulcer

- peptic has pain after meals - duodenal pain is relieved with eating

symptoms of peptic ulcer

abdominal pain and discomfort pain is in the epigastrium and doesn’t radiate diagnosed with endoscopy

how to treat peptic ulcer disease

- antacids - omeprazole

side effects of H2 antagonists

- headache - diarrhoea - confusion in elderly

cimetidine interactions

increases blood conc of erythromycin

PPI side effects

- GI upset - headache - rash

symptoms of UC and crohns

- stomach pain - weight loss - diarrhoea - tiredness

how to tell difference between UC and crohns

UC only affects the large bowel and inflammation is on the inner lining crohns can affect any area of GI and all layers can be inflamed

side effects of corticosteroids

- insomnia - dyspepsia - cushings - impaired healing

corticosteroid interactions

- grapefruit juice and budenoside - corticosteroids antagonise steroid effects

interaction between antifungals and warfarin

increases risk of bleeding cant be taken together

sulfasalazine side effect

colours urine and contact lenses orange

sulfasalazine interactions

- decreases conc of digoxin - decreases absorption of folates

ibd lifestyle advice

- smoking cessation - attention to diet/triggers

esomeprazole and omeprazole interactions

can decrease antiplatelet effect of clopidogrel

pantoprazole interactions

can increase anticoagulant effects of warfarin

diarrhoea classifications

acute is less than/= to 14 days persistant is =/over 14 dats chronic is over 30 days

symptoms of inflammatory diarrhoea

- mucoid bloody stool - tenesmus - fever - cramps - pain small, frequent bowel movements

symptoms of non inflammatory diarrhoea

- no tenesmus - bloody stool - fever - faecal leucocytes watery, large volume, frequent bowel movements

what commonly causes infectious diarrhoea

- E. coli - salmonella - c diff - norovirus - rotavirus

opioid side effects

- rebound constipation - addiction

OSCE Flashcards

(71 cards)