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Round 1: Warm Up

Q1. What is the best drug for anaphylaxis?
Adrenaline
Salbutamol
Atropine
Promethazine
Anaphylaxis is treated with adrenaline, 10 mcg / kg IM in children.
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Round 1: Warm Up

Q2. What is methoxyflurane used for?
Analgesia
Antiemesis
Laxative
Sedation
A methoxyflurane inhaler (Penthrox) can be used for acute pain in children ≥ 5. Pain relief starts after around 6 breaths.
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Round 1: Warm Up

Q3. What is benztropine used for?
Dystonic reactions
Vomiting
Bradycardia
Pain
Benztropine can be used to treat acute dystonic reactions, e.g. from Maxolon or Stemetil.
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Round 1: Warm Up

Q4. Which of these is better known as Buscopan?
Hyoscine butylbromide
Hydrocortisone
Haloperidol
Dexamethasone
Buscopan can be used for colicky abdominal pain or for respiratory secretions in palliative care. Safety and effectiveness in children younger than 6 years have not been established.
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Round 1: Warm Up

Q5. Which of these is better known as Stemetil?
Prochlorperazine
Promethazine
Chlorpromazine
Phytomenadione
Stemetil has a risk of extra-pyramidal side-effects in children and especially should not be used if <10kg.
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Bonus: History of the Doctor’s Bag

Name this bag:
Gladstone Bag
Holsworthy Bag
Surgeon’s Bag
Medi Bag
‘In use for more than a century, this mid-nineteenth century bag was created by J. G. Beard, a London leather dealer, who named it after William Gladstone, the British Prime Minister, whom he greatly admired. This bag opened widely from the top and enabled the doctor to take out whatever was needed with relative ease.’ (Dammery, D AFP 45(9):September 2016, pp636-638)
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Round 2: The PBS Doctor’s Bag

Q6. The PBS provides a limited number of medications for free in the Doctor’s Bag. Which of the following are available in the Doctor’s Bag?
Salbutamol
Prednisolone
Epipen
Aspirin
Salbutamol inhalers and nebules are included in the Doctor’s Bag, but not aspirin, prednisolone, Epipens or NSAIDs. Adrenaline is only given in a 1:1000 vial.
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Round 2: The PBS Doctor’s Bag

Q7. There are two forms of penicillin available for the Doctor’s Bag. In comparison to benzylpenicillin, procaine penicillin is:
Old and outdated
New and expensive
Cheap
Better
‘There is no emergency indication to justify the continued use of this outdated formulation.’ (Holmes, J. Aust Prescr 2012;35:7-9)
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Round 2: The PBS Doctor’s Bag

Q8. Why is lignocaine included in the Doctor’s Bag?
Anti-arrhythmia
Local anaesthesia
Sedation
General anaesthesia
Lignocaine 50mg in 5 mL was included to treat sustained VT, but IV lignocaine can worsen arrhythmias and should only be used in hospital. Outside of hospital, the priority is Basic Life Support.
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Round 2: The PBS Doctor’s Bag

Q9. For hypoglycaemia in children <5 years, what is available in the PBS Doctor's Bag medications?
Glucagon
50% dextrose
Jelly beans
Nothing
Glucagon is included in the Doctor’s Bag. For children <25kg, the dose is 0.5mg (SC, IM or IV).
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Round 2: The PBS Doctor’s Bag

Q10. If a child has ongoing generalised seizures at your GP practice, which of the following is the best initial treatment while you wait for the ambulance?
Buccal Midazolam
IM Diazepam
IV Midazolam
SC Diazepam
Midazolam was added to the PBS Doctor’s Bag medications relatively recently. It can be tricked in to the buccal mucosa without any additional requirements for IV access. IM diazepam is notoriously unreliable in absorption.
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Bonus: History of the Doctor’s Bag

Which of the following did GPs NOT routinely boil in the early 20th century?
Stethoscope
Urine
Syringes
Tongue depressors
‘Prior to the relatively recent advent of urine test strips, urine was boiled and acidified to test for protein, while glycosuria was found by boiling urine with Benedict’s reagent. ‘ (Dammery, D AFP 45(9):September 2016, pp636-638)
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