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AMC Key > AMC GP/Public Health > Flashcards

AMC GP/Public Health Flashcards

1
Q

Nicotine replacement therapy

A

Dependence with 3 criteria
Waking
No of sticks
Agitation

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2
Q

Frequency for screen colon ca

A

Asymptomatic
Low: FOBT 50-74 2 yr
Mod: FOBT 2 yr 40-49, scope 5 yr
High: FOBT 2yr 35-45, scope 5yr

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3
Q

Apnoea : refuse stop driving

A
  1. empathy advise
  2. Civil right to inform DVLA
  3. Fail, to do by the Dr
  4. Weight reduction if the cause
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4
Q

Travel to southeast Asia
Post splenecetomy
Watch out for comm disease

A

Malaria

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5
Q

Biochemical marker for CV risk

A

Waist : hip ratio
0.01 unit increase= 5% RR of CV risk

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6
Q

Relative risk or risk ratio

A

Expose gp RR= % exposed group / % unexposed or placebo X 100
Unexposed gp RR : % unexposed gp/ %exposed group X 100

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7
Q

Post exposure Hepatitis B
Pregnancy Vs non pregnant

A

Same therapy

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8
Q

Pregnancy nurse exposed to hep B+ needle stick injury.

A

No ab/<10 : IvIg & hep B vaccine 0.1.6 ( less than 72hrs, 12 hr best)
AB +( >10) : No action

*Ag + in RPT serology 3/12: baby receive IvIg and HepB 12 hrs from birth

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9
Q

Breast cancer BRCA +

A

Autosomal dominant
State funded
Eligible for genetic testing
Not by Medicare

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10
Q

BRCA candidates

A
    • BRCA gene in family
  2. Breast ca less than 30yr
  3. Breasts ca less than 40 yr with triple test negative
    Many q 66 on GP section
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11
Q

Post exposure chicken pox in a child

A

Give Vaccine ( live) within 1st 5 days of exposure ( earlier better)

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12
Q

Exposure to school Chicken pox

A

After vesicles dries off

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13
Q

Reliability of studies

A

Highest(1-4) : meta analysis}systematic review } practise guidelines} RCT
Lowest 5-9:cohort }case ctrl }cross sectional} case report) individual opinion

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14
Q

Salmonella outbreak in area. Teenage boy is infected. Important information?

A

Part time job

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15
Q

Case control Vs Cohort Vs Cross sectional Vs case report

A

Finding cause of outbreak/ disease
Vs link btw cause& effect Vs study incidence of disease in a target population within a specific period
Vs detail writing of a single case

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16
Q

Prevalence studies

A

Cross sectional studies (observational type)

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17
Q

Lipid target in IHD

A

LDL< 1.8
HDL>1.0
TG<2.0
NHDL< 2.5

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18
Q

Vaccination for febrile child

A

<38.5 : Give Vaccine
>38.5 : w/hold, give later once febrile settles
Anaphylaxis: avoid vaccine
Other conditions: Give !!!!

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19
Q

Measles incubation & symptoms

A

2 days BEFORE onset of symptoms - 4 days of RASH development
Sym: fever, conjunctivitis, Koplik spots, rash, coryza, cough (3C+R+K)

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20
Q

Measles post exposure for immunocompetent Vs immunocompromised

A

Competent but unsure of immune status : within 72hrs MMR vaccine
Sure of status: observe

Compromised: give NHIG ( MMR vaccine contraindicated for pregnant& low immunity)
Babies: preterm, upto 8mths: NHIG
9-11 mth: if <72hrs: MMR
> 72Hrs: NHIG

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21
Q

Child missed all immunization

A

Start catch up vaccination NOW!

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22
Q

Child with pneumococcal meningitis despite vaccination. Why?

A

Serotype of Invasive Pneumococcal Disease not covered in the vaccine. Current vaccine covers upto 7 serotypes, there are 90 serotypes of Strep pneumoniae

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23
Q

Q fever vaccination

A

Travel to Africa and central/south American
1-2weeks onset which lasts 10years
Single dose 0.5ml IM/Sc

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24
Q

Q fever
Important prevention

A

Vaccination!
Netting, repellant
Avoid jungles

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25
Q

Q fever symptoms

A

Same like dengue fever sx
Reservoir: monkey
Vector: aedes Aegyptus
Endemic : Africa

26
Q

CAD major risk

A

🚭 always advised cessation 1st !!!
32% risk reduction by stopping

27
Q

CAD steps in smoker with high cholesterol

A

Stop smoking
Exercise and diet
> 6/12 no changes: STatin

28
Q

Absolute CVD risk assessment calculations:

A

Age
Sex
Smoking
HDL & Total Chol
Systolic BP
DM present or not
LVF present or not

29
Q

Absolute CVD risk assessment

A

Age above 45
2 yearly check-up
Not having hx or current CVD
Does not fall under high risk

30
Q

CVA/ Stroke important Risk fx

A

Hypertension

31
Q

Attributable risk

A

a/a+b - c/c+d

32
Q

Urine Albumin creatinine ratio

A

Normal
<2.5mg)mmol MALE
<3.5mg/mmol FEMALE

33
Q

Clinical determined high risk for CVD

A

Age >60 with DM
Urine microalbumin
Urine ACR > 2.5 male, > 3.5 female
SBp > 180 ; > dbp110mmhg
eGFR 45
Familial hypercholesterolemia
Straits and Torrent Islander

34
Q

Familial hypercholesterolemia

A

Tendon xanthomas
MI death in family < 50 yrs male
<60yrs female
Very high cholesterol not related with other conditions

35
Q

Child of father with familial hypercholesterolemia

A

Pretest genetic counseling
Informed consent
Genetic testing

50% risk of being affected

36
Q

Smoking in pregnancy
Rx

A
  1. Behavioural counseling and support : initial mngt
  2. Nicotine replacement: short, intermittent therapy upto 8 weeks
    Lozenges, spray , gum, patch remove before bedtime
37
Q

Seizure for driving

A

1.Chronic seizure:
non commercial: 12mth
Commercial: 10yrs
2. 1st time seizure:
Non commercial: 6mth
Commercial: 5yrs
3. Seizure due to known causes
Eg head injury , metabolic
Non commercial: 6 mth
Commercial: 12mth
4. Epilepsy on treatment 1st time
Non commercial: 6 mth
Commercial: 10yrs
5. Breakthrough seizure:
Non commercial: 3 mth
Commercial: 10yrs
6. Dose tapering:
Non commercial: 3 mth
Commercial: review license
7. Withdrawal one of medicine:
Non commercial: 3 mth but seizure happen, maintain old meds and review 4 weeks then resume driving

38
Q

Post Stroke : can drive after

A

4 weeks

39
Q

Post Stroke assessment on fitness to drive

A
  1. Occupational therapist
    ( simulation, on road off road etc)
40
Q

1.Intermittent seizure to see well controlled for driving
2. 1 episode of breakthrough seizure , cause unknown Vs cause known

A

1:12 month free from seizure with therapy
2: cause unknown: 3 mth
Cause known: 4weeks

41
Q

Aortic aneurysm repair
Fitness to drive

A

Private: 4 weeks
Commercial: 3mth

42
Q

MI
Fitness to drive

A

Mi = P : 2 weeks C : 4 weeks
Post PCI = P : 2 days C: 4 weeks
CABG= P: 4 weeks C: 3mth
*P Private
*C Commercial

43
Q

Q 18 GP section

A

Fitness to drive chart hafal

44
Q

Father has Prostate cancer

A

Counsel benefits and risk of DRE and PSA
If agree : BOTH

45
Q

Skin Check

A

High Med/Low
Fitzpatrick type 1-6
Check q 12 GP section

46
Q

Skin cancer (doctor assessment)

A

High risk: 12 mth
Med risk: 2-5 yrs
Low risk: 1 shot skin check

47
Q

HIV post exposure prophylaxis for HCW

A
  1. 4 week therapy
  2. Baseline,6 weeks, 3 mth , 6 mth serology check
    Choice: 2 NRTI
48
Q

Post exposure Hepatitis B
Now +HbsAg

A
  1. Reassurance and Counseling
  2. 6/12 later still positive, refer to specialist
49
Q

Aboriginal common cause for blindness

A

Chlamydia trachoma»» trichiasis

50
Q

Chlamydia trachoma of eye

A

SAFE
Surgery: early entropion repair
Azithromycin
Face washing
Environmental ctrl : fly, dust

51
Q

IPV booster

A

4yrs old
Primary: 2,4,6 mth

52
Q

Obesity BMI : 30-40 no co-morbidity
Rx

A

Stepwise approach
RED
VLED
Pharmacotherapy

53
Q

VLED

A

2 meal replacement and 1 lean protein
12 weeks regiment
Aim 1-1.5kg weight loss/week

54
Q

Pre Exposure Prophylaxis HIV
(Q82 GP)

A

Receptive MSM with CLI
Receptive MSM with hx rectal Chlamydia, Gonorrhoea, Syphilis
Methamphetamine use
MSM with HIV+ve partner with undetectable viral load/not on treatment

55
Q

Eye for driving
Fail:

A

If > 6/12 in corrected eye
If > 6/18 in less eye, and > 6/9 in better eye with correction

56
Q

Gonorrhoea +

A

Treat
Notify Health Authorities
Contact tracing : 2 month
Patient referral/provider referral

57
Q

Chlamydia+ve

A

1.treat
2.notify
3. Contact tracing 6mth

58
Q

Smoking and depression treatment

A

Nicotine replacement therapy
(more nicotine dependent )
+
Varenicycline or Bupropion

59
Q

Sex worker screening (State Law)

A

3 monthly
HVS Chlamydia/ Gonorrhoea/trichomonas
Pharyngeal: as above
Vaginalvulva: warts
Blood: HIV Hep B Syphilis
Offer HepB and HepA vaccine

60
Q

MSM (RACGP) screening

A

3 To 6mth
Serology: hiv HepB Syphilis
Swab : rectal/ throat for Chlamydia/Gonorrhoea/
Urine: same above
Offer HepB HepA vaccine

AMC Key (11 decks)

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