Most Important Points for PLAB
oral morphine not tolerated + stable pain = fentanyl patches and oral
morphine not tolerated + unstable pain = s/c morphine
Patient well controlled on oral morphine but can’t tolerate oral route –
shift to transdermal patch (fentanyl)
Patient not well controlled on oral morphine and not tolerating oral
route – shift to s/c or IV morphine with dose adjustment (half dose)
Patient not able to tolerate the side effects of morphine – change to
oxycodone
Post Coital Bleeding for the first time: Cervical smear first and
depending on result colposcopy. ( sometimes with punch biposy or
core biopsy)
If PCB is persistent i.e 3 months duration etc, direct colposcopy.
Also, postmenopausal bleed most common cause is ca endometrium
and most common cause for post coital postmenopausal is also ca
endometrium is this ok till now?
ectropion we have to perform smear first if the female is on COCP. If
the qestions mentions young sexually active female then go SWAB
firs
Ca endometrium first is TVUSG then biopsy or endometrial sampling,
pneumonia+headache+confusion=legionella
H influenza and pseudomanas staphylococcus are most common
superimposed infections in CF
SOB + such high fever+ Localized pleural rub – seems Lobar
pneumonia
Pleural rub present in pneumonia, PE and pleurisy.
endomysial antibodies for celiac disease. Weight loss. Abdominal
bloating. Bulky stools etc.
Sweat test if for cystic fibrosis. There will be associated recurrent
chest infections along with abdominal symptoms.
Tft. Hypothyroidism in children. They will have prolonged jaundice
not increasing jaundice.
This woman has lower abdominal pain and a positive pregnancy test
with signs of haemodynamic instability: an ectopic pregnancy (C)
should
therefore be excluded urgently. Ovarian torsion (E) and ruptured
ovarian
cysts (A) classically present with a sudden onset abdominal pain, and
are not commonly associated with a significant tachycardic
hypotension.
Differentiating between them can be difficult. However, the natural
history of the pain is often helpful. Both may present with sudden
onset
pain, but usually the pain of ovarian torsion will be out of keeping
with
the clinical findings and will not improve with simple analgesia.
Indeed
it does not normally decrease significantly at all. By contrast, the pain
of cyst rupture, while being of sudden onset, is often reduced by
simple
analgesia and may decrease gradually as the peritoneal lining (having
been irritated by leaking fluid or blood from the cyst, causing pain)
absorbs intraperitoneal free fluid. A woman with a perforated
appendicitis
(D) would often show signs of sepsis, including fever and peritonitis,
and pain is normally localized initially to the central abdomen or right
iliac fossa. At this level of beta hCG, an intrauterine pregnancy would
normally be visible on transvaginal ultrasonography. Of the two
ectopic
pregnancy options available, cervical ectopics (B) would normally be
demonstrable on transvaginal ultrasound. Ruptured ectopic pregnancy
is a surgical emergency requiring prompt assessment, resuscitation
and
urgent surgery. The urgency of the situation is even more pronounced
if
there are signs of haemodynamic instability, such as in this case where
there is evidence of hypovolaemic shock
For osteoporosis, raloxifen
Clonidine is also used in the treatment of dysmenorrhea (severely
painful cramps during menstrual period), hypertensive crisis (a
condition in which your blood pressure is very high), Tourette’s
syndrome (a condition characterized by the need to perform repeated
motions or to repeat sounds or words), attention deficit hyperactivity
disorder (ADHD), menopausal hot flashes, and alcohol and opiate
(narcotic) withdrawal. Clonidine is also used and as an aid in smoking
cessation therapy and to diagnose pheochromocytoma (a tumor that
develops on a gland near the kidneys and may cause high blood
pressure and fast heart rate)..Incubation prd:
Polio 6-20 days
- TB 2-12 wks
- HIV 2wks or 6 months. • Syphilis 3wks -3months
Important point:
- Increased thirst
- Increased urination
- High fever • Weakness • Drowsiness • Altered mental state •
- Headache • Restlessness • Inability to speak • Visual
problems • Hallucinations • Paralysis • Warm skin that doest
not prespire
(signs of hyperglycaemic shock….)
CI OF THROMBOLYSIS (alteplase or streptokinase). ARE
Systolic BP of >200mmhg and diastolic BP >120mmhg
Recent strokes and previous TIA
Prolonged CPR a-internal bleeding b-vaginal bleeing c-
esophageal varices d-recent haemorrhagic shock in 3 months.
