QuestionMultiA
QuestionChoice
50282
g
Gliclazide;80mg;PO;OD
QuestionChoice
50284
i
Cetirizine;10mg;PO;OD
QuestionChoice
50278
c
Metformin;500mg;PO;BD
QuestionChoice
50276
a
Lithium carbonate (Liskonum);450mg;PO;OD
QuestionChoice
50279
d
Isotretinoin;20mg;PO;OD
QuestionChoice
50281
f
Fluticasone;200 micrograms;INH;BD
QuestionChoice
50277
b
Paracetamol;1mg;PO;QDS
QuestionChoice
50280
e
Salbutamol;200 micrograms;INH;QDS
QuestionChoice
50283
h
Fluoxetine;60mg;PO;OD
QuestionComment
"Some studies suggest a small increased risk of cardiovascular malformations with the use of fluoxetine, and congenital malformations (particularly cardiovascular) with the use of paroxetine, however other studies do not support an association" "The available data regarding malformation risk for all SSRIs are conflicting and confounded, and a causal association between the use of SSRIs in pregnancy, and spontaneous miscarriage, preterm delivery, low birth weight, and adverse effects on infant neurodevelopment remains unconfirmed." literally does not say anywhere to stop fluoxetine on the BNF
38695
User
subscriber
Myopathy DNA
QuestionComment
What antidepressants can be used in pregnancy?
61360
QuestionComment
sertraline and citalopram 
61549
User
subscriber
Monoclonal Polyps
User
subscriber
Cystic Gas
QuestionComment
this is dumb
61879
User
subscriber
Defibrillator Dominant
Concept
Chapter
Osteoporosis, otherwise known as thin bones, is a condition associated with high risk of low trauma fractures due to reduced bone mineral density. Osteoclast activity exceeds osteoblast activity, meaning that bone resorption is occurring at a greater rate than bone formation.

**Symptoms and Signs**

- Generally asymptomatic until a fragility fracture occurs
- Back pain
- Kyphosis (stooped posture)
- Fragility fractures

**Risk factors**

- Female sex
- Increasing age
- Smoking
- Corticosteroid use
- Low BMI (< 20-25kg/m<sup>2</sup>)
- Low body weight (<58kg)
- Vitamin D deficiency

**Protective factors**

- Higher BMI
- Exercise - mechanical loading stimulates bone formation

**Diagnosis**
Osteoporosis can be detected on dual-energy x-ray absorptiometry (DEXA) scan.
A T score of < -2.5 indicates osteoporosis

**Management**

- Fall prevention
- Vitamin D and calcium supplementation
- Hormone replacement therapy (postmenopausal women)
- Oral bisphosphonates
2657
3640
Lithium and isotretinoin are teratogenic medications and a dosing error in paracetamol
Topic
131
Obstetrics & Gynaecology/Paediatrics
1. Lithium and isotretinoin are teratogenic. Lithium is linked with an increased risk of Ebstein's anomaly occurring. Isotretinoin is linked with an increased risk of cardiovascular and ear malformations. Gliclazide should be stopped due to the increased risk of neonatal hypoglycaemia. The BNF advises that antihistamines should be avoided during pregnancy. NB: newer research now suggests that SSRIs including fluoxetine can be safely taken during pregnancy, however the pros and cons should be considered, and it should be given at the lowest effective dose.

2. The dose of paracetamol should be 1g PO QDS in this patient, 1mg is an incorrect dose.
10111
a d g i
b
Case presentation: A 28-year-old woman is attends her GP complaining of nausea in the morning.  


**PH** Bipolar disorder, asthma, type 2 diabetes mellitus, acne, allergic rhinitis

**DH** Her regular medicines are listed (below). Weight 108kg.

**Investigation**

Urinary beta hCG ++

Question 1: Select the FOUR prescriptions that she will need to stop taking given her urinary beta hCG test results (mark them with a tick in column A)

Question 2: Select the ONE prescription that contains a serious dosing error (mark it with a tick in column B).