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UKMLA Prep > General practice and primary healthcare > Flashcards

General practice and primary healthcare Flashcards

Conditions and Presentation

1
Q

Hyperparathyroidism

A

clinical condition resulting from the excessive secretion of parathyroid hormone (PTH).

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2
Q

Primary Hyperparathyroidism (PHPT) aetiology

A
  • parathyroid gland adenoma, hyperplasia of all four glands, or parathyroid carcinoma.
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3
Q

Secondary Hyperparathyroidism (SHPT)

A

Typically due to vitamin D deficiency, loss of extracellular calcium, calcium malabsorption, abnormal parathyroid hormone activity, or inadequate calcium intake.

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4
Q

Tertiary Hyperparathyroidism (THPT)

A

Occurs after prolonged secondary hyperparathyroidism due to conditions like chronic kidney disease.

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5
Q

Hyperparathyroid signs and symptoms

A
  • Moans: Painful bones
  • Stones: Renal stones
  • Groans: Gastrointestinal symptoms (nausea, vomiting, constipation, indigestion)
  • Psychiatric Moans: Neurological effects (lethargy, fatigue, memory loss, psychosis, depression)
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6
Q

Primary Hyperparathyroidism (PHPT) managment

A

Definitive management is parathyroidectomy.

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7
Q

Secondary Hyperparathyroidism (SHPT) managment

A

Address underlying causes; vitamin D supplementation and phosphate binders may be needed.

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8
Q

Tertiary Hyperparathyroidism (THPT) managment

A

Managed with medication like Cinacalcet, a calcimimetic that mimics the action of calcium on tissues, or via total or subtotal parathyroidectomy.

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9
Q

Poorly controlled hypertension, already taking an ACE inhibitor and a thiazide diuretic

A

Add calcium channel blocker

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10
Q

What are the two screening questions for depression?

A

‘During the last month, have you often been bothered by feeling down, depressed or hopeless?’ and ‘During the last month, have you often been bothered by having little interest or pleasure in doing things?’

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11
Q

What should a ‘yes’ answer to the depression screening questions prompt?

A

A more in-depth assessment

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12
Q

What tools are used to assess the degree of depression?

A
  • Hospital Anxiety and Depression (HAD) scale
  • Patient Health Questionnaire (PHQ-9)
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13
Q

What does the Hospital Anxiety and Depression (HAD) scale consist of?

A

14 questions, 7 for anxiety and 7 for depression

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14
Q

How is each item scored in the HAD scale?

A

From 0-3

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15
Q

What are the severity score ranges for the HAD scale?

A
  • 0-7: normal
  • 8-10: borderline
  • 11+: case
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16
Q

What does the Patient Health Questionnaire (PHQ-9) ask patients?

A

‘Over the last 2 weeks, how often have you been bothered by any of the following problems?’

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17
Q

How many items are included in the PHQ-9?

A

9 items

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18
Q

What is the traditional categorization of depression severity?

A
  • Subthreshold
  • Mild
  • Moderate
  • Severe
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19
Q

What is the updated NICE guideline’s definition of depression severity?

A
  • Less severe depression
  • More severe depression
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20
Q

What PHQ-9 score indicates less severe depression?

A

< 16

21
Q

What PHQ-9 score indicates severe depression?

A

≥ 16

22
Q

What are the DSM-5 criteria for diagnosing Major Depressive Disorder (MDD)?

A

Five (or more) symptoms present during the same 2-week period with at least one being depressed mood or loss of interest or pleasure.

23
Q

What are some symptoms of Major Depressive Disorder according to DSM-5? (list at least three)

A
  • Depressed mood most of the day
  • Markedly diminished interest or pleasure in activities
  • Significant weight loss when not dieting or weight gain
24
Q

What characterizes bipolar disorder?

A

Periods of mania/hypomania alongside episodes of depression.

25
Q

What is the lifetime prevalence of bipolar disorder?

A

2%

26
Q

What are the two recognized types of bipolar disorder?

A
  • Type I disorder: mania and depression
  • Type II disorder: hypomania and depression
27
Q

What defines mania?

A

Severe functional impairment or psychotic symptoms for 7 days or more.

28
Q

What defines hypomania?

A

Decreased or increased function for 4 days or more.

29
Q

What is the first-line treatment for bipolar disorder?

A

Lithium

30
Q

What should be considered in the management of mania/hypomania?

A

Stopping antidepressants if the patient takes one, and considering antipsychotic therapy.

31
Q

What are Schneider’s first rank symptoms? (list at least two)

A
  • Auditory hallucinations
  • Thought disorders
32
Q

What is chronic rhinosinusitis?

A

An inflammatory disorder of the paranasal sinuses and linings of the nasal passages lasting 12 weeks or longer.

33
Q

What are some predisposing factors for chronic rhinosinusitis? (list at least two)

A
  • Atopy (hay fever, asthma)
  • Nasal obstruction (e.g., septal deviation, nasal polyps)
34
Q

What are common features of chronic rhinosinusitis? (list at least two)

A
  • Facial pain (typically frontal pressure pain)
  • Nasal discharge (clear if allergic, thicker if infected)
35
Q

What should be avoided in the management of chronic sinusitis?

A

Allergens

36
Q

What is Samter’s triad?

A

The association of asthma, aspirin sensitivity, and nasal polyposis.

37
Q

What is factitious disorder also known as?

A

Munchausen’s syndrome

38
Q

What is malingering?

A

Fraudulent simulation or exaggeration of symptoms with the intention of financial or other gain.

39
Q

What is the definition of acute stress disorder?

A

An acute stress reaction occurring within the first 4 weeks after exposure to a traumatic event.

40
Q

What are some features of acute stress disorder? (list at least three)

A
  • Intrusive thoughts (e.g., flashbacks)
  • Dissociation (e.g., ‘being in a daze’)
  • Negative mood
41
Q

What is the first-line management for acute stress disorder?

A

Trauma-focused cognitive-behavioral therapy (CBT)

42
Q

What characterizes Obsessive-Compulsive Disorder (OCD)?

A

The presence of either obsessions or compulsions, causing significant functional impairment and/or distress.

43
Q

What is an obsession?

A

An unwanted intrusive thought, image, or urge that repeatedly enters the person’s mind.

44
Q

What is a compulsion?

A

Repetitive behaviors or mental acts that the person feels driven to perform.

45
Q

What is the peak onset age for OCD?

A

Between 10-20 years

46
Q

What is the recommended treatment for mild OCD?

A

Low-intensity psychological treatments, including cognitive behavioral therapy (CBT).

47
Q

What should be offered for severe OCD while awaiting assessment?

A

Combined treatment with an SSRI and CBT (including ERP).

48
Q

What is exposure and response prevention (ERP)?

A

A psychological method that involves exposing a patient to an anxiety-provoking situation and stopping them from engaging in their usual safety behavior.

49
Q

What is the duration for continuing SSRI treatment if effective?

A

At least 12 months

UKMLA Prep (46 decks)

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