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

Symptoms and signs suggestive of androgen deficiency in men • Incomplete sexual development, eunuchoidism, aspermia • Reduced sexual desire (libido) and activity • Decreased spontaneous erections • Breast discomfort, gynecomastia • Loss of body (axillary and pubic) hair, reduced shaving • Very small or shrinking testes (especially • Inability to father children, low or zero sperm counts • Height loss, low-trauma fracture, low bone mineral density • Reduced muscle bulk and strength • Hot flushes, sweats

Autosomal dominant inheritance is seen in: Achondroplasia, Acute intermittent porphyria, Adult polycystic kidney disease, Ehlers-Danlos syndrome, Familial adenomatous polyposis, Gilbert's syndrome, Hereditary sensory and motor neuropathy, Hereditary spherocytosis, Huntington's disease, Hyperlipidaemia type II, Malignant hyperthermia, Marfan's syndrome, Myotonia congenita, Myotonic dystrophy, Neurofibromatosis, Osteogenesis imperfecta type 1, Noonan's syndrome, Polyposis coli, Rotor syndrome, Retinoblastoma, Tuberose sclerosis, Von Hippel-Lindau disease, von Willebrand's disease

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