This document contains classical treatment recommendations for various medical conditions organized by topic. It lists conventional first-line treatments such as bisphosphonates for hypercalcemia, acetazolamide for acute mountain sickness, IV corticosteroids for pituitary apoplexy, and valproate or lamotrigine for seizure disorders. It also provides guidance on treatments for rarer conditions including hematologic diseases, neurological disorders, and cancers.
15. ▦ hyoscine is the most effective Rx
but limited use dt SEs
▦ cyclizine or cinnarizine (Non-
sedating antihistamines )
7b
BADRAWY MRCP NOTES
Classical Rx
75. ▦ reducing the frequency & duration of
relapses,There is no cure
▦ IV methylprednisolone
▦ Spasticity: baclofen & gabapentin are 1st-line
▦ β-interferon ↓ the relapse rate by up to 30%.
▦ Glatiramer acetate ➜ immunomodulating
drug
▦ Natalizumab ➜ monoclonal Ab
37b
BADRAWY MRCP NOTES
Classical Rx
137. ✺ Early (I & II) ➜ radiatiotherapy
& chemotherapy
✺ Late (III & IV) ➜ chemotherapy
alone
✺ Large mass in the chest ➜
radiatiotherapy & chemotherapy
68b
BADRAWY MRCP NOTES
Classical Rx
169. ✿ Total thyroidectomy
✿ Followed by radioiodine (I-131)
to kill residual cells
✿ Yearly thyroglobulin levels to
detect early recurrent disease
84b
BADRAWY MRCP NOTES
Classical Rx
185. ✿ Surgery is the definitive Rx
✿ Pt. must be pre-stabilized é
medical Rx
✿ α-blocker (e.g.
Phenoxybenzamine), given before a
✿ β-blocker (e.g. Propranolol)
92b
BADRAWY MRCP NOTES
Classical Rx
255. ❅ Correction o iron é IV if needed
❅ Ferritin should be > 200 ng/mL
before starting EPO
❅ EPO to target Hb 10-12
127b
BADRAWY MRCP NOTES
Classical Rx
313. ❅ NSAIDs
❅ Intra-articular steroid injection
❅ Colchicine has slower onset of action
❅ If the Pt. is already taking allopurinol it
should be continued
❅ Rasburicase when other Rx can not be
given
156b
BADRAWY MRCP NOTES
Classical Rx
314. if ≥ 2 attacks of gout in 12 month
period
157a
BADRAWY MRCP NOTES
Classical Rx
316. RA with joint inflammation
158a
BADRAWY MRCP NOTES
Classical Rx
317. ❅ a combination DMARD ASAP
❅ Methotrexate is the most widely
used DMARD
❅ analgesia, physiotherapy &
surgery.
158b
BADRAWY MRCP NOTES
Classical Rx
318. RA with joint inflammation In
Pregnancy
159a
BADRAWY MRCP NOTES
Classical Rx
319. ❅ Sulfasalazine (safe)
❅ Hydroxychloroquine (safe)
❅ Methotrexate & NSAIDs are
absolutely CI
❅ Azathiopurine can be given if the
above 2 are ineffective
159b
BADRAWY MRCP NOTES
Classical Rx
323. ❅ Synovial fluid should be obtained
before starting Rx
❅ IV antibiotics
❅ Needle aspiration for
decompression
❅ Surgical drainage if frequent
needle aspiration is required
161b
BADRAWY MRCP NOTES
Classical Rx
333. ❅ immediate ↑dose steroids ➜↓
the chance of visual loss.
❅ dramatic response should be
seen ➜if not ➜ consider another Dx
166b
BADRAWY MRCP NOTES
Classical Rx
403. ❅ Rate-limiting CCBs are often
used 1st-line
❅ Correction of hypoxia &
electrolyte disturbances
❅ Cardioversion & digoxin are not
useful
201b
BADRAWY MRCP NOTES
Classical Rx
407. ❅ Avoid drugs which prolong QT
❅ Mg+ IV
❅ β-blockers (Propranolol) not sotalol
❅ ICD if β-blockers fail
❅ Left stellate sympathectomy (if β-
blockers fail or when there is multiple ICD
shocks)
203b
BADRAWY MRCP NOTES
Classical Rx
411. ❅ Definitive Rx: radiofrequency
ablation of the accessory pathway
❅ Medical Rx: sotalol, amiodarone,
flecainide
❅ cardioversion: Flecainide is
superior to Amiodarone
205b
BADRAWY MRCP NOTES
Classical Rx
421. ❅ Thrombolytic Rx for Pts in
pulmonary edema or hypotension
(right-sided PVT)
❅ surgery is a better option for left-
sided PVT
❅ Serial echocardiography ➜ if no
response ➜ repeat thrombolytic Rx
210b
BADRAWY MRCP NOTES
Classical Rx
441. 〚1〛【Inhaled short-acting β2 agonist 】
〚2〛【Add inhaled steroid】➜beclometasone 400
〚3〛【Add inhaled long-acting β2 agonist】➜SALMETEROl
(LABA) ➜
◍ Benefit from LABA but control still inadequate➜ continue
LABA & ↑inhaled steroid to 800
◍ No response to LABA➜ stop LABA & ↑inhaled steroid to
800
〚4〛【 ↑inhaled steroid 】up to 2000 mcg/d ,± Leukotriene
✘, ,theophylline)
〚5〛【steroid tablet】+ Maintain ↑dose inhaled steroid at
2000
220b
BADRAWY MRCP NOTES
Classical Rx
442. Which Pt. should receive long-term
O₂ Rx (LTOT) ?
221a
BADRAWY MRCP NOTES
Classical Rx
443. pO2 of < 7.3 kPa or to those é a pO2
of 7.3 - 8 kPa + one of the following
▦ Secondary polycythaemia
▦ Nocturnal hypoxaemia
▦ Peripheral oedema
▦ Pulmonary HTN
221b
BADRAWY MRCP NOTES
Classical Rx
445. ❅ Before the availability of blood
gases, use a 28% Venturi mask at 4
l/min & aim for an O₂ saturation of
88-92%
222b
BADRAWY MRCP NOTES
Classical Rx
455. ❂ Primary pneumothorax
❃【Rim of air < 2cm & the Pt. is NOT DYSPNIC】 ➜
discharge
❃【Otherwise aspiration】 ➜ fails ➜ (defined as > 2 cm or
still short of breath) ➜ a chest drain
❂ Secondary pneumothorax (including Asthmatics)
❃ Pt. > 50 y +rim of air > 2cm +dyspnic➜ chest drain
❃ Otherwise ➜ attempt aspiration ➜fails ➜ chest drain
admit for 24 h
227b
BADRAWY MRCP NOTES
Classical Rx
456. Small Cell Lung Cancer
228a
BADRAWY MRCP NOTES
Classical Rx
457. ❅ Usu. metastatic disease by time
of Dx
❅ Chemotherapy (mainstay of Rx)
228b
BADRAWY MRCP NOTES
Classical Rx
463. ❅ Physical training in non-CF
bronchiectasis
❅ Postural drainage
❅ IV antibiotics for exacerbations
❅ nebulized ABX for long term
❅ Bronchodilators
❅ Immunisations
❅ Surgery in selected cases
231b
BADRAWY MRCP NOTES
Classical Rx
465. ❅ Weight loss
❅ CPAP is 1st line for moderate or
severe OSA
❅ Intra-oral devices if CPAP is not
tolerated or é mild OSA where
there is no daytime sleepiness
232b
BADRAWY MRCP NOTES
Classical Rx
517. ❅ Calamine lotion, Keep cool, trim nails
❅ School exclusion 5 days from start of
skin eruption until all lesions are crusted
❅ Immunocompromised Pts & newborns
➜ VZIG
❅ If chickenpox develops ➜ IV aciclovir
258b
BADRAWY MRCP NOTES
Classical Rx
533. ❅ azithromycin (single dose) ➜ 1st-line
❅ Doxycycline (7 day) ➜ 2nd choice
❅ If pregnant ➜ erythromycin or amoxicillin
❅ symptomatic men ➜ partners from 4 weeks
should be contacted
❅ ♀& asymptomatic men ➜ partners from the
last 6 months
❅ test of cure following Rx.
266b
BADRAWY MRCP NOTES
Classical Rx
589. ❅ Magnesium sulphate prevent seizures in
pre-eclampsia & Rx
seizures in eclampsia
❅ continue for 24 hours after last seizure or
delivery
❅ fluid restriction is essential
❅ monitor reflexes + respiratory rate while
on MgSO4
294b
BADRAWY MRCP NOTES
Classical Rx
607. ❅ Stop warfarin, give oral vitamin
K 1-5mg, repeat dose of vitamin K
if INR high after 24 hours, restart
when INR < 5.0
303b
BADRAWY MRCP NOTES
Classical Rx
623. ❅ Permethrin 5% is 1st-line
❅ Malathion 0.5% is second-line
❅ Pruritus persists for up to 4-6 weeks
post eradication
❅ All household & close physical contacts
should be Rx
Launder, iron or tumble dry clothing,
bedding, towels
311b
BADRAWY MRCP NOTES
Classical Rx
629. ✰ Narrow band ultraviolet B light
is now the Rx of choice
✰ PUVA
✰ SEs: skin ageing, squamous cell
cancer (not melanoma)
314b
BADRAWY MRCP NOTES
Classical Rx
633. ✰ resolve spontaneously within 2-3
months
✰ no firm evidence to support the use
of antibiotics
✰ Topical agents as per psoriasis
✰ phototherapy
✰ Tonsillectomy é recurrent episodes
316b
BADRAWY MRCP NOTES
Classical Rx
763. ✰ Stop warfarin, give intravenous
vitamin K 1-3mg, repeat dose of
vitamin K if INR high after 24
hours, restart when INR < 5.0
381b
BADRAWY MRCP NOTES
Classical Rx
764. T2DM, inadequate control on
metformin, at risk from
consequences of hypoglycaemia -
382a
BADRAWY MRCP NOTES
Classical Rx
765. add a DPP-4 inhibitor or a
thiazolidinedione
382b
BADRAWY MRCP NOTES
Classical Rx
801. ✰ no effective drug can retard the progression
✰ Fat-soluble vitamin supplementation
✰ Antibiotic prophylaxis during ERCP to reduce
the risk of bacterial
✰ cholangitis. Ciprofloxacin is DOCH
✰ Biliary stenting
✰ definitive treatment for PSC is hepatic
transplantation
400b
BADRAWY MRCP NOTES
Classical Rx