GP Flashcards
6 causes of cauda equina?
Malignancy:
Bony mets
Myeloma
Primary sacral tumour e.g. chordoma
Infection:
Epidural abscess
Trauma:
Disc prolapse
Epidural haematoma
What to do if a patient presents to GP with cauda equina?
Arrange urgent same day spinal surgery admission
How to tell the difference between cauda equina and cord compression?
Cauda equina compression causes flaccid paralysis with loss of reflexes
Cord compression usually causes spastic paralysis with brisk reflexes
Both cause sensory and power loss.
Red flag symptoms of lower back pain?
Bilateral sciatica Bladder dysfunction Perianal paraesthesia Gait disturbance Lower limb weakness Erectile dysfunction
SEs of metformin
GI upset - nausea & diarrhoea
Lactic acidosis (if renal failure)
Caution in RF if eGFR <30
What score can be used to calculate risk of CVD or stroke in the next 10 years? What age is it valid until?
QRisk2
84 years
Give some examples of meds used in migraine prophylaxis?
Amitryptiline
Propranolol
Topiramate
Mx of acute migraine?
Triptans
How to confirm Dx of HTN?
clinic blood pressure of 140/90 mmHg or higher AND
ABPM daytime average or HBPM average of 135/85 mmHg or higher
Beta-blocker CIs?
asthma cardiogenic shock marked bradycardia hypotension third degree AV block severe peripheral arterial disease
prophylaxis of chronic tension headache?
Amitriptyline
When to give abx in tonsillitis?
FeverPAIN score 2-3: consider delayed antibiotic prescription
FeverPAIN score 4-5: consider immediate antibiotic prescription
FeverPAIN criteria?
Fever Pus Symptom onset <3 days Inflamed tonsils No cough/coryza
Tonsillitis tx?
Penicillin V (500mg QDS for 10 days) is the treatment of choice with erythromycin or clarithromycin being the choices for those allergic to penicillin
Dukes staging colorectal cancer?
Dukes A – tumour confined to bowel wall
Dukes B – tumour has gone through wall but not into nodes
Dukes C – tumour involving regional nodes
Dukes D – distant metastases are present
How to prescribe buproprion in patients trying to quit smoking?
Bupropion 150 mg OD for 6 days, increasing to 150 mg BD for a total of 7–9 weeks
Ask them to stop smoking 7-14 days after starting buproprion
Who should get a lower dose of buproprion?
elderly
patients who have mild to moderate liver impairment
renal impairment where GFR <50 mL/min.
CIs to buproprion?
Seizures
CNS tumour
Severe hepatic cirrhosis
Hx of BPD, anorexia or bulimia
Risk of PE after AZ vaccine? What to do if they come in?
4-28 days
Send to A&E for platelet count (if low high chance)
3 types of melanocytic naevi?
Compound naevi have nests of cells at the epidermal-dermal junction as well as within the dermis. They tend to have a raised area surrounded by a flat pigmented area.
Junctional naevi have nests of cells at the epidermal-dermal junction. They tend to be flat and coloured.
Dermal naevi have nests of cells in the dermis. They tend to raised and can be skin coloured or pigmented.
Benefits of metformin?
Moderately effective glycaemic control (GC)
Weight loss
CV protection
Benefits of sulfonylureas (gliclazide)?
Highly effective glycaemic control
SEs of sulfonylureas (gliclazide)?
Risk hypos
Weight gain
Caution renal impairment
Benefits of Gliptins (Sitagliptin/Linagliptin)?
Weight neutral
Good in CKD
