General Practice Flashcards
Diabetes for 2 years, smoker for 50 years, only on metformin, BP 135/65. Blood tests: Normal lipids, HbA1c. Normal ACR. Next step?
a) Assess motivation to cease smoking
b) Perindopril (ACEi)
c) Increase metformin dose
d) Insulin
Assess motivation to cease smoking
Man wants to quit smoking. Has tried in the past, and once made it 2 months. In addition to setting
a quit
smoking date what else to offer?
Psychological counselling Hypnotherapy
NRT
Cognitive behavioural therapy
Brief cessation advice in GP consult Acupuncture
NRT - most effective
Lady in 30s presents with 3 days of pain in lower back of relatively acute onset, that radiates into buttock but no further. No neurological signs. Started on pain relief. What further investigations to do?
a) No investigations needed, bed rest
b) No investigations needed, stay active/maintain normal activity
c) MRI spine
d) Plain X-ray
e) CT spine
No investigations needed, stay active/maintain normal activity
Young man comes into the GP with back pain. They have pain on palpating of paraspinal muscles and on spine extension, flexion and lateral flexion. What investigation?
a) Lumbar x-ray
b) No further treatment and mobilise
c) No further treatment and bed rest
d) CT
e) MRI
No further treatment and mobilise
Testicular cancer screening: Guy got a mate with testicular cancer, worried, came to see GP, no symptom, examination show left testis lower and slightly bigger than right one, best next management?
a) Reassurance
b) Encourage regular self-examination
c) Encourage yearly doc visit for examination
d) Referral for USS
Encourage regular self-examination
34 year old female wanting screening for breast cancer: no FHx, no symptoms, normal breast exam
a) Reassurance
b) Sign up to breast screening
c) BRCA mutation testing
Reassurance
Guy seeing his GP who smokes 20/day, drinks alcohol (11 drinks/week) and wears a seatbelt for 75% of the time and weighs 84kg and he is 175cm tall. Hypertensive at 150/90. What advice would be best for his health?
a) Smoking cessation
b) Drink less
c) Lose 14kg
d) Wear seatbelt 100% of the time
e) Give a thiazide
Smoking cessation
Guy coming in for minor ankle thing. Find out he’s drinking heaps of alcohol (10 mega pints at night and 2 glasses of wine with lunch) denies he has a drinking problem. What do you do
a) Discuss safe levels of drinking
b) Information on alcoholic anonymous
c) Trial of disulfiram
d) Advise to immediately stop drinking any alcohol
Discuss safe levels of drinking
Guy who was 68. Fhx two brothers who had prostate cancer in their 60s. He had a PSA that had gone from 3.5-5.5 in 1 year. He has had some urinary symptoms like decreased stream. His prostate was smooth and no obvious masses felt.
a) Transperineal biopsy
b) Repeat PSA in 3 months
c) MRI prostate
d) Ultrasound prostate
Repeat PSA in 3 months
This is BPH
50 year old man comes in worried as friend had recently been diagnosed with prostate cancer screening. He is asymptomatic. What should your course of action be?
a) Do not screen as he is asymptomatic
b) Do PSA and DRE
c) Do biopsy
d) Discuss pros and cons of screening
Discuss pros and cons of screening
