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NV Finals Revision > General practice > Flashcards

General practice Flashcards

1
Q

Name 3 health professionals who look after children until the age of 10.

A

community midwife: pregnancy and few weeks after birth

community health visitor: until the age of 5

school nurse: 5 to 10. does the hearing vision test.

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2
Q

Name 3 things recorded in the Personal Child Health Record or the red book.

A

Height
Weight

Vaccinations

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3
Q

What are the main concerns to look for in a NIPE screening programme for newborns or infants?

A

Congenital Heart Disease
Developmental Dysplasia of the Hip (DDH)

Congenital cataracts
Undescended testes

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4
Q

What are the common sites for osteoarthritis?

A

Weight bearing joints

Knees and hip and spine

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5
Q

Give two articular features of osteoarthritis.

A
  1. loss of cartilage

2. formation of new bone

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6
Q

What is the typical presentation of osteoarthritis?

A

> 45yo
pain and stiffness in weight bearing joints

stiffness in the morning/after rest lasting no longer than 30 mins
pain and stiffness worse with movement and exercise

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7
Q

What are the red flag symptoms for a musculoskeletal condition?

A

back pain < 25yo
worsening back pain >55yo

Hx of cancer
steroid use
HIV positive
weight loss
structural deformities
night pain and sweats
saddle anaesthesia
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8
Q

Give examples of non-pharmacological management of osteoarthritis.

A

weight loss
walking aids

exercise and physiotherapy
electrotherapy- transcutaneous electrical nerve stimulation (esp back pain)
appropriate footwear

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9
Q

Give examples of pharmacological management of osteoarthritis.

A

topical capsaicin
paracetamol

NSAIDs (with PPI)
intra-articular corticosteroid injections

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10
Q

Describe the analgesic ladder.

A

Mild pain: non-opioids: NSAIDs, aspirin, paracetamol
Moderate pain: mild opioids: codeine (constipation), dihrydrocodeine

Severe pain: strong opioids: morphine, tramadol, pethidine, diamorphine, fentanyl

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11
Q

What are the side effects of opioids?

A

nausea, vomiting, constipation, drowsiness, respiratory depression, hypotension, addiction and itching

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12
Q

What is a characteristic side effect of tramadol?

A

Serotonin syndrome

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13
Q

What are the side effects of NSAIDs?

A

stroke, high blood pressure, tinnitus, peptic ulcer, indigestion

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14
Q

What are the possible side effects of paracetamol?

A

Nausea, loss of appetite, leucopenia, low blood pressure, diarrhoea.

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15
Q

How do you treat morphine overdose?

A

IV naloxone

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16
Q

How do you treat paracetamol overdose?

A

IV N-acetylcysteine

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17
Q

What tool would you use to assess a patient’s risk of developing cardiovascular disease in the next 10 years?

A

QRISK3

18
Q

What does the Dipeptidyl peptidase 4 inhibitor, pioglitazone, increase the risk of?

A

heart failure, bladder cancer, bone fracture

19
Q

What does a diabetic review involve?

A

Blood glucose test- HbA1c
Blood pressure check

Cholesterol check
Eye screening
Foot and leg exam
Renal function test
Advice on diet
Emotional and psychological support
Free flu jab
Sexual health concerns
20
Q

Name some complications of diabetes.

A

Neuropathy
Nephropathy

Retinopathy
Cardiovascular disease
Foot damage and gangrene
Hearing impairment
Skin conditions
Depression
21
Q

Give 3 causes of MI.

A
  1. coronary atherosclerosis
  2. coronary thrombus
  3. reduced blood flow to heart due to shock or haemorrhage
22
Q

What are the side effects of corticosteroids?

A 
immunosuppression
loss of bone density
mood
weight gain
hypertension
diabetes mellitus
23
Q

What would you expect to see on an X-ray of a joint with rheumatoid arthritis?

A

osteophyte formation

24
Q

Give 3 examples of DMARDs.

A

Methotrexate
Sulfasalazine
Azathioprine

25
Q

Why should sulfasalazine not be given to men?

A

reduces sperm count causing subfertility

26
Q

What signs and symptoms should a patient on myelosuppressants (chemo, azathioprine) look out for?

A

sore throat, fever, unexplained bruising or bleeding

27
Q

Define chronic kidney disease.

A

The presence of kidney damage (albuminuria) or decreased kidney function (glomerular filtration rate < 60 ml/minute per 1.73 m^2) for 3 months or more, irrespective of clinical diagnosis.

28
Q

What are the risk factors for CKD?

A 
proteinuria
CVD
AKI
hypertension
diabetes mellitus
smoking
African, afro-Caribbean, Asian family origin
chronic use of NSAIDs
29
Q

Describe the stages of CKD.

A

Stage 1: normal: >90
Stage 2: mild impairment: 60-89

Stage 3a: moderate impairment: 45-60
Stage 3b: moderate impairment: 30-45
Stage 4: severe impairment: 15-30
Stage 5: end-stage renal disease/established renal failure: <15 or on dialysis

30
Q

What does renal replacement therapy include?

A

haemodialysis, peritoneal dialysis, chronic ambulatory peritoneal dialysis, renal transplantation

31
Q

Give 3 benefits and 3 risks of transplantation.

A

Benefits: improved quality of life, no need for dialysis, reversal of anaemia and renal bone disease
Risks: immediate operative complications (infection, pain, pneumonia, DVT), immediate graft failure, arterial or venous thrombosis in the transplant, side effects of immunosuppressive drugs.

32
Q

What are the contra-indications to peritoneal dialysis?

A

Abdominal adhesions, stoma, obesity, intestinal disease, respiratory disease, hernias.

33
Q

What does haemodialysis involve?

A

Blood is drawn from an arteriovenous fistula and circulated through a dialyser before being returned to the body.

34
Q

What does peritoneal dialysis involve?

A

A dialysate is infused into the peritoneal cavity and the blood flowing through the peritoneal capillaries acts as the blood source.

35
Q

What are the risks of breast cancer screening?

A

overtreatment
unnecessary distress

missed diagnosis
x-ray radiation exposure during mammogram

36
Q

Who is offered breast cancer screening?

A

Women aged 50 to 71 who are registered with a GP, every 3 years

37
Q

What happens if someone has an abnormal breast screening result?

A

more mammograms, breast examination, ultrasonography, biopsy

38
Q

Give 5 symptoms of breast cancer.

A 
breast lump
nipple colour change
nipple discharge (might be bloody)
axillary lumps
breast pain
39
Q

Give 5 risk factors of breast cancer.

A 
Personal or family history of breast cancer
BRCA-1 or BRCA-2 gene or TP53 mutation
increased age
obesity after menopause
Increased exposure to oestrogen
40
Q

What are the complications of breast cancer treatment?

A

arm mobility, lymphoedema, menopausal symptoms, neutropenic sepsis

41
Q

What are the criteria for the genetic screening of BRCA?

A

More than 2 relatives who have had breast cancer before 50
relative who has developed breast cancer in both breasts
male family history of breast cancer
eastern European heritage
jewish

42
Q

What is the pharmacological treatment of depression?

A

fluoxetine (SSRI)

marplan (MAOi)

NV Finals Revision (27 decks)

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