General Practice Flashcards
What are the causes/risk factors for the developmental of heart failure?
- Hypertension
- Heart Valve Disease
- Excess alcohol
- Ischaemic Heart Disease
- Cardiomyopathy
- Arrythmias
- Congenital Heart Disease
- Severe anaemia
What are the causes of high-output Heart Failure?
- Anaemia
- Pregnancy
- Paget’s disease
What are the causes of Low-output heart Failure?
- MI
- Excessive preload
- Chronic hypetension
What GENERAL symptoms do you get with a patient with heart failure?
- Dyspnoea
- Fatigue
- Weight loss
- Wheeze
What symptoms are more specific to left ventricular heart failure?
- Orthopnoea
- Paroxysmal nocturnal dyspnoea
- Nocturnal cough
What symptoms are more specific to right ventricular heart failure?
- Facial engorgement
- Peripheral oedema
- Anorexia
- Raised JVP/pulsation of the neck
What bloods test would be needed in heart failure?
- U&Es
- BNP
- Creatinine
- Albumin
What investigations, in addition to bloods, would you do in suspected heart failure?
- Chest X-ray
- ECG
- Echocardiogram
- Exercise stress test
What is the management for heart failure with low ejection fraction?
First-line: ACE inhibitor and Beta blocker
Second line: Add spironolactone
Later: Digoxin and other specialist medication can be given if symptoms persist
What is the most likely reason for hypertension?
Unknown - 85% of hypertension is primary with no known cause
What are the causes of secondary hypertension?
- Renal disease e.g. renal artery stenosis, scarring, polycystic
- Primary aldosteronism
- Drugs e.g. COP, corticosteroids, SNRI antidepressants, cocaine, amphetamines
- Uncommon e.g. Conn’s, Csuhing’s and phaechromocytoma
What blood pressure is stage 1?
> 140/90
What blood pressure is stage 2?
> 160/100
What blood pressure is stage 3?
Systolic >180 and/or Diastolic >110
What is the hypertension treatment pathway (stages of treatment) for a 52 year old caucasian man?
- ACE-inhibitor or ARB
- Combine with CCB
- Add thiazide-like diuretic
What is the hypertension treatment pathway for a 57 year old man?
- CCB
- Combine with ACE-I/ARB
- Add thiazide like diuretic
Give an example of a thiazide-like diuretic
- Bendroflumethiazide
A lady presents with vaginal itching and irritation. She also complains of a discharge which she likens to cottage cheese. In addition to this she complains of soreness and stinging on urination. What is the most likely diagnosis?
Thrush (Candida infection)
What causes thrush?
Candida albicans
What is the treatment for thrush?
intravginal cream or pessary e.g. Clotimazole, econazole, miconazole or fenticonazole
A lady presents complaining of a smell discharge from her vagina. She is embarrassed because the smell is similar to that of fish. On examination the discharge is thin and white. What is the likely diagnosis?
Bacterial vaginosis
What is the treatment fo bacterial vaginosis?
Antibiotic tablets or gel - Metronidazole or Clindamycin
A lady presents complaining of an abnormal discharge from her vagina. She describes it as thick, yellow/green in colour with some mild irritation. What is the likely diagnosis?
Trichomoniasis
What is the cause of trichomoniasis?
Trichomonas vaginalis
What is the treatment for trichomoniasis
Metronidazole (5 to 7 days)
What activities can increase the risk of developing bacterial vaginosis?
- Washing with perfumed soaps
- Having bubble baths
- Using vaginal washes
- Using strong washing detergents
- Being sexually active
- Changing partner
- Intrauterine Device
What are the clinical features of hypoglycaemia?
Hunger, trembling, sweating, anxiety, fast pulse palpitations, tingling of the lips, blurred vision, difficulty concentrating, confusion, loss of consciousness and seizures
What are the clinical features of hyperglycaemia?
Polyuria, polydipsia, headaches, tiredness, lethargy, blurry vision
What are the clinical features of diabetic ketoacidosis?
Severe dehydration, frequent vomiting, abdominal pain, polyuria, flushed cheeks, hyperventilation, ketotic breath, progressive loss of consciousness, shock
