AMC EXAMS AUSTRALIA ,AUSTRALIAN MEDICAL EXAMS,MCQS,CLINICALS.

Features of oral isotretinoin treatment • For patients with severe acne • For patients unresponsive to conventional therapy • For acne patients experiencing psychological distress • Extremely effective, as it targets all causes of acne • Duration of treatment and daily dose are individualised • Low starting dose is used that may be gradually increased, as tolerated • Side effects are usually manageable • Warn of mood changes and the potential risk of depression • Warn about contraception and teratogenicity

Features of oral isotretinoin treatment • For patients with severe acne • For patients unresponsive to conventional therapy • For acne patients experiencing psychological distress • Extremely effective, as it targets all causes of acne • Duration of treatment and daily dose are individualised • Low starting dose is used that may be gradually increased, as tolerated • Side effects are usually manageable • Warn of mood changes and the potential risk of depression • Warn about contraception and teratogenicity

Tips for antibiotic therapy • Do not use topical and oral antibiotics at the same time • Use oral antibiotics for a 6-12-week course • If a longer course of oral antibiotics is required, use benzoyl peroxide for a week between courses • Warn of side effects of antibiotic therapy, particularly photosensitivity with doxycycline

IMPORTANT POINTS HISTORY AND EXAMINATION History • How long have you had pimples for? • Are there any triggers? • Is there a family history? • What treatments have you had? How long did you follow each treatment? • What was the most effective treatment? Why did you stop it? • How do you feel about your skin? Does it stop you from doing anything? Examination • Assess the severity and whether there is any scarring. • Determine any psychological impact.

Box 1: Nine ingestants that can be lethal in toddlers in low doses • Calcium channel blockers • Camphor • Imidazolines (eg, clonidine) • Cyclic antidepressants • Lomotil • Opiates • Salicylates • Sulphonylureas • Toxic alcohols Note: Not in order of lethality

A patient with successfully treated DVT remains at increased risk of DVT or PE for life and will need prophylaxis at times. Prophylaxis (with, for example, enoxaparin 40mg daily) should begin 12 hours before elective surgery. In orthopaedic surgery, it should be continued at this dose for three weeks after discharge from hospital2. Early remobilisation and compression stockings should be used routinely for all surgery. Intra-operative calf compression machines are often used in prolonged elective surgery. High-risk medical patients (eg, those likely to be inpatients for more than five days) should receive routine prophylaxis whether or not they have had a prior DVT. Seek advice if the patient has renal impairment because LMW heparins accumulate quickly in patients with moderate to severe renal failure. All women with previous DVT or artificial heart valves should receive daily heparin prophylaxis during pregnancy. Haematological review is recommended in those with diagnosed thrombophil...

A patient with successfully treated DVT remains at increased risk of DVT or PE for life and will need prophylaxis at times. Prophylaxis (with, for example, enoxaparin 40mg daily) should begin 12 hours before elective surgery. In orthopaedic surgery, it should be continued at this dose for three weeks after discharge from hospital2. Early remobilisation and compression stockings should be used routinely for all surgery. Intra-operative calf compression machines are often used in prolonged elective surgery. High-risk medical patients (eg, those likely to be inpatients for more than five days) should receive routine prophylaxis whether or not they have had a prior DVT. Seek advice if the patient has renal impairment because LMW heparins accumulate quickly in patients with moderate to severe renal failure. All women with previous DVT or artificial heart valves should receive daily heparin prophylaxis during pregnancy. Haematological review is recommended in those with diagnosed thrombophil...