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general Flashcards

1
Q

Procedures at a practice level to ensure abnormal test results are followed up

A
  1. Phonecall to patient by nursing / medical staff to ensure follow up appt is made for abnormal result
  2. Registered mail send to patient requesting them to make follow up appt to discuss results
  3. Flag abnormal results on computer system to be discussed at next appt
  4. Ensure appropriate documentation that abnormal result has been discussed with the patient
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2
Q

Medication to maintain alcohol abstinence

A
  1. Acamprosate
  2. Naltrexone
  3. Disulfiram
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3
Q

Symptoms of lithium toxicity

A
  1. Diarrhoea
  2. Nausea and vomiting
  3. Tremor
  4. Ataxia
  5. Dysarthria
  6. Confusion
  7. Seizures
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4
Q

DDx LUTS

A
  1. UTI
  2. STI
  3. Urethral sticture
  4. BPH
  5. Prostate cancer
  6. Bladder cancer
  7. Constipation
  8. Interstitial cystitis
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5
Q

Mx options BPH

A
  1. Alpha adrenoreceptor antagonist - Tamsulosin
  2. 5alpha reductase inhibitor - Dutasteride
  3. Reduce caffeine consumption
  4. Reduce evening fluid intake
  5. Ensure bowels regular, increase fibre intake
  6. Pelvic floor exercises / bladder training
  7. Surgical mx
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6
Q

Examination of scrotal swelling

A
  1. Ability to transilluminate
  2. Position of scrotal swelling
  3. Consistency of scrotal mass
  4. Tethered or mobile swelling
  5. Prehn’s sign (relief with lifting scrotum)
  6. Fever
  7. Testicular / scrotal tenderness
  8. Cough impulse
  9. Cremasteric reflex
  10. Rashes or ulceration to scrotum / penis
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7
Q

Pharmacology options for smoking cessation

A
  1. NRT
  2. Varenicline (avoid in end stage CKD)
  3. Bupropion (contraindicated in seizures)
  4. Nortryptiline
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8
Q

Major risk factors for osteoporosis

A
  • hx minimal trauma fracture
  • height loss > 3cm
  • back pain suggestive of vertebral fracture
  • female
  • age > 70
  • hx falls
  • parental hx hip fracture
  • premature menopause or hypogonadism
  • prolonged use glucocorticoids ( 3months > 7.5mg/day)
  • low body weight
  • low muscle mass & strength
  • low physical activity or prolonged immobility
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9
Q

Advantages of NOAC medication

A
  1. Fixed dosing regimen
  2. Lack of required monitoring
  3. Fast onset and offset of action
  4. Fewer drug and food interactions
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10
Q

Falls prevention in the elderly

A
  1. Exercise program incorporating balance - tai chi
  2. Home modifications
  3. Multidisciplinary assessment
  4. Prompt cataract operation, when needed
  5. Medication reviews
  6. Avoiding bifocal glasses, especially outdoors
  7. Correction of any existing postural hypotension
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11
Q

Osteoporosis prevention

A
  1. Exercise strength training and high-impact weight bearing exercise 3-5 / times per week 30 mins
  2. Calcium intake of 3-5 serves calcium rich foods / day 1300mg/day post menopausal or 1000mg/day pre
  3. Smoking cessation
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12
Q

Important things to consider in caring for elderly people with chronic disease

A
  • Assess capacity, for example, with a mini mental state examination
  • Enquire about enduring power of attorney
  • Discuss advanced healthcare directive
  • Try to arrange appointments with a trusted family member to explain important aspects of care
  • Arrange for a health assessment (falls risk)
  • Consider referral to ACAT (home services)
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13
Q

Potential causes for delirium in pt with CKD

A
  • Anaemia secondary either to renal failure or from gastrointestinal (GI) blood loss
  • CVA
  • Change in calcium levels
  • Worsening renal function leading to uraemic encephalopathy
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14
Q

Presumptive therapy for bite injuries

A
  • amoxicillin + clavulanate 875/125mg BD 3/7
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15
Q

Risk factors for erectile dysfunction

A
  • smoking
  • diabetes
  • obesity
  • hyperlipidaemia
  • HTN
  • new beta blocker
  • anxiety / depression
  • hypogonadism
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16
Q

Clinical presentation of OSA

A
  • excessive daytime sleepiness and tiredness
  • nocturnal problems (loud snoring)
  • morning headache
  • subtle neuropsychiatric disturbance (loss of concentration)
  • sexual dysfunction
  • occupational and driving problems
17
Q

Causes of excessive somnolence

A
  • inadequate sleep duration
  • sleep apnoea syndromes
  • narcolepsy
  • endocrine (hypothyroidism)
  • drug induced
  • purposeful sleep deprivation
  • nocturnal myoclonus
  • bereavement
  • idiopathic
18
Q

Medical causes of restless leg syndrome

A
  • anaemia
  • iron deficiency
  • uraemia
  • hypothyroidism
  • pregnancy
  • drugs (antihistamines, anti-emetics)
19
Q

Pharmacological mx restless leg syndrome

A
  • Clonazepam 0.5-1mg one hour before bed
  • Levodopa / Carbidopa 100-200mg

More severe symptoms

  • Pramipexole 0.125mg daily, increasing to 0.75mg
20
Q

Typical features of chronic fatigue syndrome

A
  • extreme exhaustion with minimal exertion
  • headache or ‘fuzzy’ feeling in the head
  • aching in muscles and legs
  • poor concentration and memory
  • hypersomnia
  • waking feeling tired
  • emotional lability / anxiety
  • depressive type illness
  • sore throat
  • subjective feeling of fever (normal temp)
  • SOB
  • swollen, tender lymph nodes
21
Q

DDx burning feet

A
  • diabetic neuropathy
  • vitamin B12 deficiency
  • arterial claudication
  • erythromyalgia
  • psychogenic
  • chillblains / Raynaud’s phenomenon
  • tarsal tunnel syndrome
  • Morton’s neuroma
22
Q

Mx chillblains (perniosis)

A
  • potent topical steroid Diprosone 0.5% BD
  • Nifedipine 20mg SR daily
  • thick socks, enclosed footwear
  • warm with warm water
  • exercise indoors
  • smoking cessation
23
Q

Non-pharmacological mx of known osteoporotic crush fracture

A
  • ensure adequate calcium intake 1300mg daily
  • sunlight exposure for vitamin D 15 mins / day
  • balance / resistance training
  • falls prevention strategies
  • smoking cessation
  • reduce alcohol intake
24
Q

Discussion points prior to prescribing Denosumab

A
  • importance of adhering to 6 monthly regime
  • needs to be continued indefinitely (risk of spontaneous fracture if withdrawn)
  • serious adverse effects: osteonecrosis jaw
  • can cause hypocalcaemia (needs to be replete Ca)
  • adequate vitamin D prior to commencement
  • renal function checked prior
  • may still have a # whilst on tx, necessitate change in tx
25
Q

DDx for genital ulcers

A
  • HSV
  • syphilis (primary, painless)
  • apthous ulcers
  • chemical burns
  • dermatitis
  • autoimmune (Bechets)
  • fixed drug reaction
  • gram + skin infection
26
Q

Tx options for genital warts

A
  • imiquimod 5% cream 3 x / week until resolution
  • podophylloton 0.5% paint twice daily for 3 days / week
  • cryotherapy
  • no tx required unless desired by pt

GP (10 decks)

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