Common GP Diseases Flashcards
Causes of arrhythmias
Ischaemic heart disease/post-MI Electrolyte imbalance (hyperkalaemia) Hypertension Valvular disease Hyperthyroid disease Heart failure Rheumatic fever
ECG of atrial fibrillation
Irregular irregular heart rate
Absent P waves
Abnormal QRS complex
Drugs for atrial fibrillation
Rate control = beta-blocker or calcium channel blocker
Anti-coagulate = warfarin or aspirin
Risk of stroke with AF
CHA2DS2-VASc score
Assessment of risk of DVT
Wells score
Risk factors for DVT
Old age Pregnancy Surgery Obese Immobility Cancer Previous DVT Smoking
Signs of a DVT
Unilateral! Warm, swollen calf/leg Vein distension Tenderness in leg Change in skin colour/erythema. Pitting odema
Investigations for a DVT
D-dimer (not diagnostic as not specific)
Ultrasound of leg veins
Management of DVT
LMWH or fondaparinux and long-term warfarin
Compression stockings
Reduce risks with lifestyle advice.
Difference between asthma and COPD
Asthma = reversible! COPD = variable reversibility, progressive. Less diurnal variation
Pathophysiology of COPD
Emphysema (histologically enlarged air spaces) and bronchitis (cough, excess sputum)
Pink puffer
Increased alveolar ventilation
Normal PaO2, normal or low PaCO2
Barrel chest, hyperinflation
Type 1 resp failure
Blue bloaters
Cyanosis, decreased alveolar ventilation.
CO2 retention
Obese
Complications of DM
Vascular disease - MI, stroke
Nephropathy
Retinopathy
Neuropathy
4 drugs for type 2 diabetes mellitus
Metformin (increase insulin sensitivity, lower weight)
Sulfonylurea (increase insulin secretion)
Insulin injections
Glitazone (increase insulin sensitivity)
Hypothalamus, pituitary, thyroid and organ axis
Hypothalamus release TRH–>anterior pituitary releases TSH –> thyroid releases T4 (thyroxine) and T3 –> T4 converted to T3 at end organ.
Name some investigations for thyroid disease
Free T4 and T3
TSH
Thyroid Antibodies e.g. TSH-R antibody, TPO antibody.
Symptoms of over-active thyroid
Diarrhoea Weight loss with increased appetite Tremor Sweat and heat intolerance Irritability
Signs of over-active thyroid
Goitre AF and tachycardia Warm skin Fine tremor Thin hair Exophthalmos with lid lag, lid retraction (esp Graves)
Drugs for over-active thyroid
Carbimazole = anti-thyroid drug
Beta-blockers for symptomatic control
Radioiodine
Thyroidectomy
Complication of hyperthyroid
Thyroid storm
Causes of hypothyroidism
Congenital (picked up on Guthrie test)
Post-thyroidectomy/over treatment of hyerpthyroid
Primary atrophic hypothyroidism
Hashimoto’s thyroiditis
Symptoms fo hypothyroid
Constipation Sleepy and tired Depression Cold intolerance Increased weight Menorrhagia Cramps and weakness
Signs of hypothyroidism
Hyporeflexia Dry brittle hair Oedema and ascites Goitre CCF
