Common GP Diseases

Question 1

Causes of arrhythmias

Answer 1

Ischaemic heart disease/post-MI
Electrolyte imbalance (hyperkalaemia)
Hypertension
Valvular disease
Hyperthyroid disease
Heart failure
Rheumatic fever

Question 2

ECG of atrial fibrillation

Answer 2

Irregular irregular heart rate
Absent P waves
Abnormal QRS complex

Question 3

Drugs for atrial fibrillation

Answer 3

Rate control = beta-blocker or calcium channel blocker

Anti-coagulate = warfarin or aspirin

Question 4

Risk of stroke with AF

Answer 4

CHA2DS2-VASc score

Question 5

Assessment of risk of DVT

Answer 5

Wells score

Question 6

Risk factors for DVT

Answer 6

Old age
Pregnancy
Surgery
Obese
Immobility
Cancer
Previous DVT
Smoking

Question 7

Signs of a DVT

Answer 7

Unilateral!
Warm, swollen calf/leg
Vein distension
Tenderness in leg
Change in skin colour/erythema.
Pitting odema

Question 8

Investigations for a DVT

Answer 8

D-dimer (not diagnostic as not specific)

Ultrasound of leg veins

Question 9

Management of DVT

Answer 9

LMWH or fondaparinux and long-term warfarin
Compression stockings
Reduce risks with lifestyle advice.

Question 10

Difference between asthma and COPD

Answer 10

Asthma = reversible!
COPD = variable reversibility, progressive. Less diurnal variation

Question 11

Pathophysiology of COPD

Answer 11

Emphysema (histologically enlarged air spaces) and bronchitis (cough, excess sputum)

Question 12

Pink puffer

Answer 12

Increased alveolar ventilation
Normal PaO2, normal or low PaCO2
Barrel chest, hyperinflation
Type 1 resp failure

Question 13

Blue bloaters

Answer 13

Cyanosis, decreased alveolar ventilation.
CO2 retention
Obese

Question 14

Complications of DM

Answer 14

Vascular disease - MI, stroke
Nephropathy
Retinopathy
Neuropathy

Question 15

4 drugs for type 2 diabetes mellitus

Answer 15

Metformin (increase insulin sensitivity, lower weight)
Sulfonylurea (increase insulin secretion)
Insulin injections
Glitazone (increase insulin sensitivity)

Question 16

Hypothalamus, pituitary, thyroid and organ axis

Answer 16

Hypothalamus release TRH–>anterior pituitary releases TSH –> thyroid releases T4 (thyroxine) and T3 –> T4 converted to T3 at end organ.

Question 17

Name some investigations for thyroid disease

Answer 17

Free T4 and T3
TSH
Thyroid Antibodies e.g. TSH-R antibody, TPO antibody.

Question 18

Symptoms of over-active thyroid

Answer 18

Diarrhoea
Weight loss with increased appetite
Tremor
Sweat and heat intolerance
Irritability

Question 19

Signs of over-active thyroid

Answer 19

Goitre
AF and tachycardia
Warm skin
Fine tremor
Thin hair
Exophthalmos with lid lag, lid retraction (esp Graves)

Question 20

Drugs for over-active thyroid

Answer 20

Carbimazole = anti-thyroid drug
Beta-blockers for symptomatic control
Radioiodine
Thyroidectomy

Question 21

Complication of hyperthyroid

Answer 21

Thyroid storm

Question 22

Causes of hypothyroidism

Answer 22

Congenital (picked up on Guthrie test)
Post-thyroidectomy/over treatment of hyerpthyroid
Primary atrophic hypothyroidism
Hashimoto’s thyroiditis

Question 23

Symptoms fo hypothyroid

Answer 23

Constipation
Sleepy and tired
Depression
Cold intolerance
Increased weight
Menorrhagia
Cramps and weakness

Question 24

Signs of hypothyroidism

Answer 24

Hyporeflexia
Dry brittle hair
Oedema and ascites
Goitre
CCF

Question 25

Management of hypothyroidism

Answer 25

Levothyroxine (T4)

Question 26

Adult sepsis ABx

Answer 26

Co-amoxiclav and gentamicin

Question 27

Adult community-acquired pneumonia ABx

Answer 27

Amoxicillin