GP🧑🏽⚕️ Flashcards
1
Q
What is stage one hypertension?
A
Over 140/90
2
Q
What is stage two hypertension?
A
Over 160/100
3
Q
What is Severe hypertension?
A
> 180 systolic >100 diastolic
4
Q
What is accelerated hypertension?
A
Hypertension with associated severe papilloedema and retinal haemorrhage
5
Q
What blood tests can you do in primary care for hypertension?
A
HbA1c, U&Es, lipid profile
6
Q
What antihypertensive would you start in an over 55?
A
Calcium channel blocker
7
Q
What investigations can you do in primary care for COPD?
A
- A CXR to exclude other pathologies
- FBC to identify anaemia or polycythaemia
- Sputum culture
- Social home peak flow measurements
- ECG and serum BNP
- ECHO
8
Q
What might cause hypertension?
A
Essential/primary hypertension
Secondary Hypertension
- Cushing’s Disease
- Conn’s Syndrome
- Renal artery stenosis
- Coarctation of the aorta
- Pheochromocytoma
- Renal disease (PKD, Glomerulonephritis)
9
Q
What are some non-modifiable risk factors for HTN?
A
Older age, FHx, Ethnicity Female
10
Q
What are some modifiable factors for HTN?
A
Overweight, high salt intake, lack of activity, excess alcohol, stress
11
Q
What investigation might you do for HTN in primary care?
A
End organ damage
- 12 lead ECG +/- echo
- U+E and eFR and urine drip
- Renal USS
CVD risk
- Blood glucose
- Fasting lipids
Secondary causes
- 24 hours urinary metanephrines
- Dexamethasone suppression
- Renin/Aldosterone ratio
12
Q
How do you diagnose diabetes?
A
Random blood glucose - >11 mmol/L
Fasting blood glucose - >7 mmol/L
Glucose tolerance test - >11.1 mmol/L at 2 hour
Hba1c – 48 mmol/mol (6.5%)
13
Q
What lifestyle advice do you give for a patient with T2DM?
A
- Healthy diet - low fat and sugar
- Increase exercise
- Smoking cessation
- Trial for 3 months then drug treatment
14
Q
Risk factors for COPD?
A
- Tobacco smoking
- Occupational exposure
- Air pollution
- Alpha-1-antitrypsin deficiency (also causes cirrhosis and liver failure in a minority)
15
Q
What is the management of COPD?
A
1.SABA (salbutamol) or SAMA (ipratropium)
2. LABA (salmeterol) or LAMA (tiotropium)
3. If on LABA, add on ICS. If declined/not tolerated/still symptomatic, add LAMA
4. If on LAMA, add LABA plus ICS
Maximum therapy is LAMA+LABA+ICS+SABA
Two other rules - 1) Stop SAMA if prescribing LAMA
- 2) Don’t use ICS monotherapy
16
Q
When would you consider oxygen in COPD?
A
Consider in:
<30% FEV1
Cyanosis
Polycythaemia
Peripheral oedema
Raised JVP
O2 sats <92%
17
Q
What is the prognosis of Heart failure?
A
50% die within 5 years of diagnosis
40% die or are re-admitted in 1 year
18
Q
What are some poor prognostic indicators for HF?
A
-Reduced ejection fraction
-Comorbidities
-Worsening symptoms and signs
-Obesity/cachexia
-Smoking
-MI history
19
Q
What are the signs and symptoms of HF?
A
Less specific - breathlessness, fluid retention, fatigue, syncope
More specific – orthopnoea, PND
Less specific – tachycardia, hypertension, tachypnoea, basal creps, oedema, obesity, heart murmurs
More specific – displaced apex, gallop rhythm, raised JVP, hepatomegaly, ascites
20
Q
How do you diagnose HF?
A
ECG in everyone
Consider CXR, U+E, eGFR, FBC, TFTs, LFT, HbA1c, lipids, urinalysis
If history of MI, refer to cardio and organise echo within 2 weeks
If no history of MI, measure natriuretic peptide (BNP or NT-pro-BNP)
- If normal, heart failure unlikely
- If raised, refer to cardio and organise echo
21
Q
How do you manage heart failure?
A
Review drugs to see if contributing to symptoms
Prescribe loop diuretic for symptomatic relief
Prescribe both an ACE-I and a B-blocker
Start one at a time, no recommended order
Refer if still symptomatic
Consider anti-platelet treatment
Consider statin therapy
Annual flu, and 1x pneumococcal, vaccines
Cardiac rehab
22
Q
By which mechanism does ACEi cause a cough?
A
Bradykinin accumulation
23
Q
How do you assess febrile child in primary care?
A
General appearance
- Temp
- Heart rate
- Resp rate
- CRT
- Fluid status
(Consider BP if HR or CRT abnormal)
Examine chest
Examine throat (NOT epiglottitis)
24
Q
Red- high risk signs for paediatric illness in primary care
A
- Pale/mottled/ashen blue
- No response to vocal cues
- Appears sick to a healthcare professional
- Does not wake if roused
- Weak, high-pitched or continuous cry
- Resp signs –> Grunting, tachypnoea, RR>60breaths/minute, moderate or severe chest indrawing
- Reduced skin turgor
- Age <3months temperature >38C
- Non-blanching rash
- Bulging fontanelle
- Neck stiffness
- Status epilepticus / focal seizures
- Focal neurological signs
25
Overview of bronchiolitis in children?
-RSV, <1 year old, winter
-Coryza, fever, irritable cough, rapid breathing, difficulty feeding
-Tachypnoea, tachycardia, widespread crepitation -+/- high-pitched wheeze
-Management depends on severity of symptoms
-High risk – premature babies, babies < 6 weeks, underlying lung disease/congenital heart disease/immunosuppression.
26
Overview of croup?
Viral, autumn and spring
Mild fever and runny nose. Inspiratory stridor and barking cough – usually at night (<4 year).
Steam. Oral steroids – oral dex or pred
27
How will Kawasaki present in primary care?
Kawasaki – Vasculitis. >5 fever 5 days, bilateral conjunctivitis, polymorphous rash, strawberry tongue and lips, reddening or palms/soles, cervical lymphadenopathy singular large painful. Urgent referral. IV immunoglobulin and aspirin.
28
What is blindness?
inability to perform any work for which eyesight is essential. <3/60 vision.
(Partial sightedness – usually 3/60 – 6/60.)
29
What are some red flags for red eye?
Decreased visual acuity, pain deep in eye, absent/sluggish pupils, corneal damage, trauma
30
How does retinal vein occlusion present?
Sudden - typically on waking +/- afferent pupil defect
Retina – Pizza/storm sunset
Glaucoma, HTN, polycythaemia, cholesterol
Laser tx, intraocular steroids/growth factors
31
How does retinal artery occlusion present?
Sudden - afferent pupil defect
Retina – White +/- cherry red spot at macula
Thromboembolism
Treat risk factors. No reliable tx. Optic atrophy and blindness.
32
How does a vitreous haemorrhage present?
Sudden decreased vision, loss of red reflex, difficulty seeing retina
Diabetes, bleeding disorders, trauma, tumour, central retinal vein, retinal detachment
33
How does a retinal detachment present?
Painless – curtain
Symptoms pre-detachment – floaters/flash
Idiopathic, trauma, DM, myopia
Central vision depends on macula
34
Define the two types of age-related macular degeneration?
Most common cause of blindness in UK.
Dry – Atrophy of neuroretina. Macula cells break down and results in drusen formation.
Wet – Drusen lifts the retinal pigment epithelium from the bloods supply. New blood vessels grow from the choroid and can bleed forming scars.
35
What is the management of AMD?
Food supplements – can slow progression
Treat co-existing conditions
(Some biologics in secondary care)
Social support – IMPORTANT. Visual aids, register blindness, information, help groups/forums, blue badge parking scheme, disability living allowance.
36
What is Presbyacusis?
Common.
Bilateral sensorineural deafness in >50 years.
Gradual onset
High frequencies more severely affected
Examination normal
Audiology and hearing aids
37
What is noise-induced sensorineural deafness?
– Exposure >85 dB.
Bilateral
Occupational/non-occupational
Acute/gradual onset from repeated exposure
Immediate signs – ringing in ears/muffling
Audiology and hearing aids
Compensation/ear protection.
38
What is an acoustic neuroma?
Slow-growing – neurofibroma from acoustic nerve
Unilateral
Can get tinnitus and facial palsy
Refer to ENT
39
What is Meniere's disease?
Idiopathic dilatation of endolymphatic spaces
Clustering of attacks of vertigo and nausea , tinnitus, sense of fullness, sensorineural deafness which can be progressive.
Minutes – hours
Refer to ENT
Acute attacks - Can give labrynthine sedatives, encourage to mobilise after, try and identify trigger
Long-term – meds, low-salt diet, vestibular rehab, hearing aids/tinnitus maskers
40
What is otosclerosis?
Adherence of stapes footplate to bone
Bilateral conductive hearing loss
FH
Refer to ENT – surgery
41
What is cholesteatoma?
Skin/stratified squamous epithelium in middle ear.
Retraction pocket in pars flaccida.
Local expansion can cause damage to local structures
Can get infected – offensive smell
Refer to ENT - surgery
Look out for red flags such as facial nerve palsy.
42
What is the incubation period of measles?
10-18 days. Infectious from 5 days before start of symptoms until rash appears
43
What are the Gillick competency and Fraser guidelines?
1. Girl under 16 year will understand advice
2. Cannot persuade to tell parents
3. Likely to continue having sexual intercourse with/without tx
4. Unless she receives contraceptive advice her physical +/ mental health will suffer
5. Best interests require contraception without parental consent
44
What is the action of N-acetylcysteine?
Replenishes body stores of glutathione so that NAPQI can be converted to a less toxic product, preventing hepatocyte damage.
45
What can be used to reverse heparin?
Protamine
46
What is the management used post-MI?
ACEi + Beta Blocker + Statin + Aspirin + Clopidogrel
47
What is the most common nail sign of iron deficiency anaemia?
Koilonychia
48
What joints does osteoarthritis most commonly affect?
Large joints or joints of the hand
49
What crystals are seen in pseudogout?
Positively Birefringent crystals.
Calcium pyrophosphate
50
How do you calculate alcohol unit?
Units = Strength (ABV) x Volume (ml)
1000
51
What is the CENTOR Criteria?
Used to assess whether ABx are needed in acute tonsillitis
- History of fever
- Tonsillar exudates
- No cough
- Tender anterior cervical lymphadenopathy
52
What is the NICE criteria for diagnosing atopic dermatitis
itchy skin + 3/5 of:
Visible flexural eczema*
History of flexural eczema*
History of dry skin
History of asthma or allergic rhinitis (or history of atopy in 1st degree relative if <4 years)
Onset <2 years old (do not use if <4 years old)
or on the cheeks/extensors in children <18 months
53
What is the epidemiology of COPD?
An estimated 1.2 million people are living with diagnosed COPD in the UK, representing around 2% of the population. Around 30,000 people die from COPD each year, representing 26% of deaths from lung disease.
54
What are the spirometry stages of COPD?
Spirometry: FEV1 <80% of predicted; FEV1/FVC <0.7
Stage 1 Mild FEV1 ≥ 80% predicted
Stage 2 Moderate FEV1 50-79% of predicted
Stage 3 Severe FEV1 30-49% of predicted
Stage 4 Very Severe FEV1 <30% of predicted
55
What are UKMEC 4 criteria?
Absolute contraindications to contraception:
- Known or suspected pregnancy
- Smoker over the age of 35 who smokes >15 cigarettes
- Obesity
- Breast feeding <6 weeks post partum
- Fx of thrombosis before 45 years old
- Breast cancer or cancer within the last few years
- BRCA genes
56
What are UKMEC 3 Criteria?
Disadvantages of contraception outweigh the advantages:
- Breast feeding >6 weeks post partum
- Previous arterial or venous clots
- Continued use after heart disease or stroke
- Migraine with aura
- Active diseases of liver or gallbladder
57
What are UKMEC 2 criteria?
Advantages of a contraceptive outweigh the disadvantages:
- Initiation after current or past history of MI or stroke
- Multiple risk factors for arterial cardiovascular disease
58
What is ellaOne and how does it work?
ellaOne (ulipristal acetate (UPA)) is a progesterone receptor modulator that works by inhibiting or delaying ovulation.
It is licensed for use within 120 hours (5 days) of unprotected sexual intercourse (UPSI).
ellaOne advises against use in women with severe asthma controlled with oral steroids, and in those with severe liver impairment.
Breast feeding must be avoided for one week after taking the medication.
59
How long can you not drive with a one off seizure?
Car/ motorbike license = Reapply in 6 months
Bus/Lorry/Coach license = Reapply in 5 years if you haven't taken anti-epileptic medications for 5 years
60
How long can you not drive with more than one seizure?
Car/Motorbike License = Reapply in one year
Bus/Coach/Lorry = Reapply once you haven't had a seizure for 10 years or you haven't taken any anti-epileptic medications for 10 years
61
How are salmonella and shigella treated?
Ciprofloxacin
62
How is Campylobacter treated?
Macrolide such as erythromycin
63
What crystals are seen in gout?
Needle-shaped monosodium urate crystals with negative birefringence
64
What is the criteria for commencing prophylactic allopurinol in gout?
- More than 2/3 attacks per year
- Tophaceous gout
- X-Ray changes showing chronic destruction joint disease
- Urate nephrolithiasis
- Patient experiencing severe and disabling polyarticular attacks
65
What is the management of haemorrhoids?
Grade 1 haemorrhoids (i.e. no prolapse) can be managed conservatively, ± topical corticosteroids to alleviate pruritus.
Grade 2 haemorrhoids (i.e. prolapse on straining which spontaneously reduces) can be managed with rubber band ligation (preferred), sclerotherapy, or infrared photocoagulation.
Grade 3 haemorrhoids (i.e. prolapse on straining and require manual reduction) are managed with rubber band ligation.
Grade 4 haemorrhoids (i.e. prolapse on straining and can't be manually reduced), external haemorrhoids, or lower grade haemorrhoids failing to respond to less invasive measures are managed with surgical haemorrhoidectomy. All patients should be advised to consume a diet rich in fibre and fluids, to reduce the risk of constipation.
66
What is the management of haemorrhoids?
Grade 1 haemorrhoids (i.e. no prolapse) can be managed conservatively, ± topical corticosteroids to alleviate pruritus.
Grade 2 haemorrhoids (i.e. prolapse on straining which spontaneously reduces) can be managed with rubber band ligation (preferred), sclerotherapy, or infrared photocoagulation.
Grade 3 haemorrhoids (i.e. prolapse on straining and require manual reduction) are managed with rubber band ligation.
Grade 4 haemorrhoids (i.e. prolapse on straining and can't be manually reduced), external haemorrhoids, or lower grade haemorrhoids failing to respond to less invasive measures are managed with surgical haemorrhoidectomy. All patients should be advised to consume a diet rich in fibre and fluids, to reduce the risk of constipation.
67
What are the risks of HRT?
Increased risk of breast cancer
Increased risk of endometrial cancer if oestrogen given alone
Increased risk of venous thromboembolism
67
What are the risks of HRT?
Increased risk of breast cancer
Increased risk of endometrial cancer if oestrogen given alone
Increased risk of venous thromboembolism
68
What is Levonelle and how does it work?
Levonelle (Levonorgestrel) is a progesterone only tablet that should be taken within 72 hours (3 days) of unprotected sexual intercourse (UPSI). It works by inhibiting ovulation by delaying or preventing follicular rupture and causing luteal dysfunction.
69
What is Levonelle and how does it work?
Levonelle (Levonorgestrel) is a progesterone only tablet that should be taken within 72 hours (3 days) of unprotected sexual intercourse (UPSI). It works by inhibiting ovulation by delaying or preventing follicular rupture and causing luteal dysfunction.
70
What is medial epicondylitis?
Medial epicondylitis, 'golfer's elbow' occurs due to tendinopathy of the wrist flexor tendons which attach to the medial epicondyle of the distal humerus. These include flexor carpi radialis, pronator teres, palmaris longus, flexor digitorum superficialis and flexor carpi ulnaris. Patients typically report gradual-onset medial elbow pain exacerbated by activity, particularly flexion of the wrist.
71
What is olecranon bursitis?
Olecranon bursitis is inflammation of the olecranon bursa.
It will classically occur after repetitive damage, such as leaning on the elbow.
Examination reveals a swelling directly over the olecranon which is fluctuant with no signs of infection.
72
What is Pityriasis rosea?
Pityriasis rosea is a common rash which often occurs after an upper respiratory tract infection and is thought to have a viral cause (HHV 6/7).
73
What are the clinical features of pityriasis rosea?
It is characterized by a preceding herald patch - a single, large, discoid (coin-shaped), erythematous patch. This patch classically has a 'collarette' of scale just inside the edge of the lesion. A few days later a widespread rash appears across the trunk consisting of multiple small, erythematous, scaly patches (similar but smaller than the herald patch). These lesions are classically distributed across the trunk in a 'christmas tree' pattern.
74
What is the management of Raynaud's Phenomena?
The first line pharmacological treatment is dihydropyridine calcium channel blockers which can reduce both frequency and severity of attacks. Other options include ACE inhibitors and IV prostacyclin. In extreme cases nerve blocks or digital amputation might be necessary.
75
What are the stages of AKI?
1: Creatinine is 1.5-1.9 times higher than baseline/ urine output < 0.5ml/kg for > 6 consecutive hours
2: Creatinine is 2-2.9 times higher than baseline/ urine output < 0.5ml/kg for > 12 consecutive hours
3: Creatinine is >3 times higher than baseline / urine output < 0.5ml/kg for > 24 consecutive hours/
anuria for > 12 hours
76
What drugs can cause an AKI?
NSAIDs, ACEi, ARBs, CCBs, Alpha blockers, Beta blockers, opioids, diurectics, acyclovir, trimethoprim, lithium and more
77
What is the treatment for a gastric ulcer and H.Pylori infection?
Lifestyle changes and 1 PPI+ 2 Antibiotics such as clarithromycin and metronidazole
78
What is Menieres disease?
Long term progressive vestibular condition affecting balance and hearing parts of the inner ear
79
How does Menieres disease present?
Ménière’s disease symptoms may include:
Dizziness or vertigo (attacks of a spinning sensation)
Hearing loss
Tinnitus (a roaring, buzzing, or ringing sound in the ear)
Sensation of fullness in the affected ear
Symptoms tend to come and go together
80
What are the classical features of IBS?
ABC features
Abdominal pain, bloating, and change in bowel habit.
80
What are the classical features of IBS?
ABC features
Abdominal pain, bloating, and change in bowel habit.
81
What is the treatment of schistosomiasis?
Praziquantel
82
How do statins work?
Inhibit HMG CoA reductase, reducing cholesterol synthesis.
83
What is angina?
Angina is a symptom which occurs as a consequence of restricted coronary blood flow.
84
What investigations can you do for angina in primary care?
12 lead ECG- often normal
ECHO
85
What drug treatments would you offer a person with stable angina?
- Prescribe sublingual glyceryl trinitate for rapid relief of symptoms
- Prescribe a beta-blocker or a calcium-channel blocker
86
What is heart failure?
An inability of the heart to deliver blood at a rate commensurate with the requirements of metabolising tissues
87
Describe the NYHA classification?
Class I: No limitation (asymptomatic)
Class II: Slight limitation (mild HF)
Class III: Marked limitation (symptomatically moderate)
Class IV: Inability to carry out any physical activity without discomfort
88
What would you see on CXR for HF?
Alveolar oedema
Kerley B lines
Cardiomegaly
Dilated upper lobe vessels of lungs
Effusions (pleural)
89
What is intermittent claudication?
It is moderate ischemia which normally affects the calves.
90
What is seen in Type 1 respiratory failure?
pO2 is low
pCO2 is low or normal
91
What is the spirometry results for obstructive lung disease?
FEV1/FVC below 0.7 FEV1 lower than FVC. Seen in asthma, COPD, bronchiectasis
92
What investigations would you do for IBS?
DIAGNOSIS OF EXCLUSION
screen for colon cancer in those over 40
Full bloods:
FBC, ESR, TTG/EMA antibodies
thyroid function tests if symptoms of thyroid disease are present
stool samples to exclude GI infection if diarrhoea is present
93
What is the antibiotic treatment for UTI?
Males : 7 days of nitrofurantoin
Females: 3 days of Nitrofurantoin
Immunosuppression/recurrent: 7 days of ciprofloxacin
Pregnancy: 3-7 days of ciprofloxacin
94
What are people with Down syndrome at risk of?
Alzheimer's Dementia
95
What investigations for Dementia can you do in primary care?
You can do 6-CIT and MMSE
96
What is the definition of Intellectual disability?
It means a significantly reduced ability to understand new or complex information and to learn and apply new skills (impaired intelligence)
97
What is a temporary patient?
Someone who is in the area for more than 24 hours and less than 3 months
98
Groups that are exempt from NHS charges?
Refugees, asylum seekers, people receiving support under section 95 of the immigration and asylum act, children looked after by the local council, victims, and suspected victims of modern slavery or human trafficking, prisoners and immigration detainees
99
What is the treatment of Impetigo?
Topical (fusidic acid, mupirocin) or systemic (flucloxacillin or clarithromycin)
100
What is the treatment for eczema herpeticum?
Oral acyclovir, systemic antibiotics for secondary bacterial infection
101
What is the treatment for Scabies?
Hygiene advice, topical permethrin, oral ivermectin
102
What is the treatment of tinea capitis?
Systemic treatment with Oral Griseofulvin/terbinafine
103
What are the recommendations for Metformin if a person is fasting during Ramadan?
As most will take their main meal after sunset (Iftar) and then have an early morning meal before sunrise (Suhoor), current guidance suggests splitting metformin into one third with Suhoor and two thirds with their main meal at Iftar.
104
What is the best investigation to guide GP management for Heart failure?
NT-proBNP
105
What test do you use to check for H.Pylori eradication?
Urea Breath test
106
What blood test results would you see in Osteoporosis?
Normal ALP, normal Calcium, Normal phosphate, Normal PTH
107
What sport should be avoided in ED and why?
Cycling can cause ED as it puts constant pressure on the perineum - this can slow down blood flow and lead to ED
108
What guidelines are used in giving contraceptives to a girl under 16 years of age?
Fraser Guidelines
109
What is the second line treatment for gout if Allopurinol is not tolerated?
Febuxostat - A non-purine selective xanthine oxidase inhibitor that reduces the production of uric acid
110
What blood tests are seen in an individual with alcoholic liver disease?
Increased ALT + Increased AST with an AST/ALT ratio of 2:1
111
What blood tests are seen in an individual with alcoholic liver disease?
Increased ALT + Increased AST with an AST/ALT ratio of 2:1W
112
What is the most common bacteria causing COPD exacerbations?
Moraxella Cararrhalis, Haemophilus influenzae and Streptococcus pneumoniae
113
What is the BMI of an obese individual?
30-34.9
114
What is the Jarman index?
This is used to quantify 'deprived' areas. It has now been replaced by the Carr-Hill formula
115
What is the Carr-Hill allocation formula used for?
Used to adjust the global sum total for a number of local demographic and other factors which may affect practice work load
116
What is the Carr-Hill allocation formula used for?
Used to adjust the global sum total for a number of local demographic and other factors which may affect practice work load
117
What is the first line management of pericarditis?
NSAIDs
118
What is the management for Wolff-Parkinson-White syndrome?
Ablation of the accessory pathway
119
What thyroid disease is often preceded by a viral infection and what is the treatment?
De Quervain's thyroiditis. Treatment is symptomatic and there is usually no role for antithyroid medications
120
What is the appropriate screening test for Cushing's Syndrome?
24- hour urinary free cortisol measurement
121
What is the medical management of acute limb ischaemia?
High flow oxygen and initiation of an unfractionated heparin infusion
122
What are the criteria for longterm oxygen therapy in COPD?
PaO2 <7.3 when stable
PaO2 7.3-8kPa when stable and also have either secondary polycythaemia, peripheral oedema or evidence of pulmonary hypertension
123
What is the treatment for Salmonella?
Ciprofloxacin
124
What will Legionella Pneumophilia look like on blood results?
125
What do you prescribe for HTN when ACEi and CCB aren't controlling BP?
A thiazide-like diuretic such as Indapamide
126
What do you do when a patient's BP is not controlled by ACEi+CCB+Thiazide-like diuretic?
Consider seeking expert advice or add a
- Low dose spironolactone (if Potassium is less than 4.5mmol/L)
- Alpha-blocker or Beta-blocker (if blood potassium is more than 4.5mmol/L)
127
What is the first-line rate control in AF?
Bisoprolol or a rate limiting CCB
128
When would you immediately start alendronic acid without doing a DEXA scan?
If >65 and on long-term steroids
129
What is the first line treatment for Non-bullous localised Impetigo?
Hydrogen peroxide 1% cream
For individuals who are systemically well
130
What do you use in widespread non-bullous impetigo?
Offer a short course of a topical or oral antibiotic for exam Fusidic acid 2%
Alternative for if Fusidic acid is unsuitable or is there is resistance is Mupirocin 2%.
131
What antibiotic should you use for Bullous impetigo for patients who are systemically unwell?
First line oral antibiotic is Flucloxacillin 500mg four times a day for five days
If penicillin allergic - Clarithromycin 250mg twice a day for 5 days
132
What is the Glasgow-Blatchford risk score used for?
Upper GI Bleed
133
What is the PERC risk score used for?
Pulmonary embolisms
134
When is the screening programme for AAA in UK?
All men in England are offered a screening ultrasound scan at age 65 to detect asymptomatic AAA.
135
What is Buerger's test used for?
Peripheral arterial disease
136
BNP of what level requires urgent specialist referral for echocardiogram (within 2 weeks)?
Levels >2,000ng/L
137
BNP of what level requires specialist referral for ECHO within 6 weeks?
400-2,000ng/L
