Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Phase 3a Medicine🩺 > GP🧑🏽‍⚕️ > Flashcards

GP🧑🏽‍⚕️ Flashcards

1
Q

What is stage one hypertension?

A

Over 140/90

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is stage two hypertension?

A

Over 160/100

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is Severe hypertension?

A

> 180 systolic >100 diastolic

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is accelerated hypertension?

A

Hypertension with associated severe papilloedema and retinal haemorrhage

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What blood tests can you do in primary care for hypertension?

A

HbA1c, U&Es, lipid profile

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What antihypertensive would you start in an over 55?

A

Calcium channel blocker

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What are some non-modifiable risk factors for HTN?

A

Older age, FHx, Ethnicity Female

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What are some modifiable factors for HTN?

A

Overweight, high salt intake, lack of activity, excess alcohol, stress

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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%)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

When would you consider oxygen in COPD?

A

Consider in:
<30% FEV1
Cyanosis
Polycythaemia
Peripheral oedema
Raised JVP
O2 sats <92%

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

What are some poor prognostic indicators for HF?

A

-Reduced ejection fraction
-Comorbidities
-Worsening symptoms and signs
-Obesity/cachexia
-Smoking
-MI history

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

By which mechanism does ACEi cause a cough?

A

Bradykinin accumulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

Overview of bronchiolitis in children?

A

-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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

Overview of croup?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

How will Kawasaki present in primary care?

A

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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is blindness?

A

inability to perform any work for which eyesight is essential. <3/60 vision.
(Partial sightedness – usually 3/60 – 6/60.)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

What are some red flags for red eye?

A

Decreased visual acuity, pain deep in eye, absent/sluggish pupils, corneal damage, trauma

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

How does retinal vein occlusion present?

A

Sudden - typically on waking +/- afferent pupil defect
Retina – Pizza/storm sunset
Glaucoma, HTN, polycythaemia, cholesterol
Laser tx, intraocular steroids/growth factors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
31
Q

How does retinal artery occlusion present?

A

Sudden - afferent pupil defect
Retina – White +/- cherry red spot at macula
Thromboembolism
Treat risk factors. No reliable tx. Optic atrophy and blindness.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
32
Q

How does a vitreous haemorrhage present?

A

Sudden decreased vision, loss of red reflex, difficulty seeing retina
Diabetes, bleeding disorders, trauma, tumour, central retinal vein, retinal detachment

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
33
Q

How does a retinal detachment present?

A

Painless – curtain
Symptoms pre-detachment – floaters/flash
Idiopathic, trauma, DM, myopia
Central vision depends on macula

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
34
Q

Define the two types of age-related macular degeneration?

A

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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
35
Q

What is the management of AMD?

A

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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
36
Q

What is Presbyacusis?

A

Common.
Bilateral sensorineural deafness in >50 years.
Gradual onset
High frequencies more severely affected
Examination normal
Audiology and hearing aids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
37
Q

What is noise-induced sensorineural deafness?

A

– 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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
38
Q

What is an acoustic neuroma?

A

Slow-growing – neurofibroma from acoustic nerve
Unilateral
Can get tinnitus and facial palsy
Refer to ENT

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
39
Q

What is Meniere’s disease?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
40
Q

What is otosclerosis?

A

Adherence of stapes footplate to bone
Bilateral conductive hearing loss
FH
Refer to ENT – surgery

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
41
Q

What is cholesteatoma?

A

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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
42
Q

What is the incubation period of measles?

A

10-18 days. Infectious from 5 days before start of symptoms until rash appears

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
43
Q

What are the Gillick competency and Fraser guidelines?

A
  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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
44
Q

What is the action of N-acetylcysteine?

A

Replenishes body stores of glutathione so that NAPQI can be converted to a less toxic product, preventing hepatocyte damage.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
45
Q

What can be used to reverse heparin?

A

Protamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
46
Q

What is the management used post-MI?

A

ACEi + Beta Blocker + Statin + Aspirin + Clopidogrel

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
47
Q

What is the most common nail sign of iron deficiency anaemia?

A

Koilonychia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
48
Q

What joints does osteoarthritis most commonly affect?

A

Large joints or joints of the hand

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
49
Q

What crystals are seen in pseudogout?

A

Positively Birefringent crystals.
Calcium pyrophosphate

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
50
Q

How do you calculate alcohol unit?

A

Units = Strength (ABV) x Volume (ml)
1000

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
51
Q

What is the CENTOR Criteria?

A

Used to assess whether ABx are needed in acute tonsillitis
- History of fever
- Tonsillar exudates
- No cough
- Tender anterior cervical lymphadenopathy

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
52
Q

What is the NICE criteria for diagnosing atopic dermatitis

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
53
Q

What is the epidemiology of COPD?

A

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.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
54
Q

What are the spirometry stages of COPD?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
55
Q

What are UKMEC 4 criteria?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
56
Q

What are UKMEC 3 Criteria?

A

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
Q

What are UKMEC 2 criteria?

A

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
Q

What is ellaOne and how does it work?

A

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
Q

How long can you not drive with a one off seizure?

A

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
Q

How long can you not drive with more than one seizure?

A

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
Q

How are salmonella and shigella treated?

A

Ciprofloxacin

62
Q

How is Campylobacter treated?

A

Macrolide such as erythromycin

63
Q

What crystals are seen in gout?

A

Needle-shaped monosodium urate crystals with negative birefringence

64
Q

What is the criteria for commencing prophylactic allopurinol in gout?

A
  • 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
Q

What is the management of haemorrhoids?

A

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
Q

What is the management of haemorrhoids?

A

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
Q

What are the risks of HRT?

A

Increased risk of breast cancer
Increased risk of endometrial cancer if oestrogen given alone
Increased risk of venous thromboembolism

67
Q

What are the risks of HRT?

A

Increased risk of breast cancer
Increased risk of endometrial cancer if oestrogen given alone
Increased risk of venous thromboembolism

68
Q

What is Levonelle and how does it work?

A

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
Q

What is Levonelle and how does it work?

A

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
Q

What is medial epicondylitis?

A

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
Q

What is olecranon bursitis?

A

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
Q

What is Pityriasis rosea?

A

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
Q

What are the clinical features of pityriasis rosea?

A

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
Q

What is the management of Raynaud’s Phenomena?

A

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
Q

What are the stages of AKI?

A

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
Q

What drugs can cause an AKI?

A

NSAIDs, ACEi, ARBs, CCBs, Alpha blockers, Beta blockers, opioids, diurectics, acyclovir, trimethoprim, lithium and more

77
Q

What is the treatment for a gastric ulcer and H.Pylori infection?

A

Lifestyle changes and 1 PPI+ 2 Antibiotics such as clarithromycin and metronidazole

78
Q

What is Menieres disease?

A

Long term progressive vestibular condition affecting balance and hearing parts of the inner ear

79
Q

How does Menieres disease present?

A

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
Q

What are the classical features of IBS?

A

ABC features
Abdominal pain, bloating, and change in bowel habit.

80
Q

What are the classical features of IBS?

A

ABC features
Abdominal pain, bloating, and change in bowel habit.

81
Q

What is the treatment of schistosomiasis?

A

Praziquantel

82
Q

How do statins work?

A

Inhibit HMG CoA reductase, reducing cholesterol synthesis.

83
Q

What is angina?

A

Angina is a symptom which occurs as a consequence of restricted coronary blood flow.

84
Q

What investigations can you do for angina in primary care?

A

12 lead ECG- often normal
ECHO

85
Q

What drug treatments would you offer a person with stable angina?

A
  • Prescribe sublingual glyceryl trinitate for rapid relief of symptoms
  • Prescribe a beta-blocker or a calcium-channel blocker
86
Q

What is heart failure?

A

An inability of the heart to deliver blood at a rate commensurate with the requirements of metabolising tissues

87
Q

Describe the NYHA classification?

A

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
Q

What would you see on CXR for HF?

A

Alveolar oedema
Kerley B lines
Cardiomegaly
Dilated upper lobe vessels of lungs
Effusions (pleural)

89
Q

What is intermittent claudication?

A

It is moderate ischemia which normally affects the calves.

90
Q

What is seen in Type 1 respiratory failure?

A

pO2 is low
pCO2 is low or normal

91
Q

What is the spirometry results for obstructive lung disease?

A

FEV1/FVC below 0.7 FEV1 lower than FVC. Seen in asthma, COPD, bronchiectasis

92
Q

What investigations would you do for IBS?

A

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
Q

What is the antibiotic treatment for UTI?

A

Males : 7 days of nitrofurantoin
Females: 3 days of Nitrofurantoin
Immunosuppression/recurrent: 7 days of ciprofloxacin
Pregnancy: 3-7 days of ciprofloxacin

94
Q

What are people with Down syndrome at risk of?

A

Alzheimer’s Dementia

95
Q

What investigations for Dementia can you do in primary care?

A

You can do 6-CIT and MMSE

96
Q

What is the definition of Intellectual disability?

A

It means a significantly reduced ability to understand new or complex information and to learn and apply new skills (impaired intelligence)

97
Q

What is a temporary patient?

A

Someone who is in the area for more than 24 hours and less than 3 months

98
Q

Groups that are exempt from NHS charges?

A

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
Q

What is the treatment of Impetigo?

A

Topical (fusidic acid, mupirocin) or systemic (flucloxacillin or clarithromycin)

100
Q

What is the treatment for eczema herpeticum?

A

Oral acyclovir, systemic antibiotics for secondary bacterial infection

101
Q

What is the treatment for Scabies?

A

Hygiene advice, topical permethrin, oral ivermectin

102
Q

What is the treatment of tinea capitis?

A

Systemic treatment with Oral Griseofulvin/terbinafine

103
Q

What are the recommendations for Metformin if a person is fasting during Ramadan?

A

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
Q

What is the best investigation to guide GP management for Heart failure?

A

NT-proBNP

105
Q

What test do you use to check for H.Pylori eradication?

A

Urea Breath test

106
Q

What blood test results would you see in Osteoporosis?

A

Normal ALP, normal Calcium, Normal phosphate, Normal PTH

107
Q

What sport should be avoided in ED and why?

A

Cycling can cause ED as it puts constant pressure on the perineum - this can slow down blood flow and lead to ED

108
Q

What guidelines are used in giving contraceptives to a girl under 16 years of age?

A

Fraser Guidelines

109
Q

What is the second line treatment for gout if Allopurinol is not tolerated?

A

Febuxostat - A non-purine selective xanthine oxidase inhibitor that reduces the production of uric acid

110
Q

What blood tests are seen in an individual with alcoholic liver disease?

A

Increased ALT + Increased AST with an AST/ALT ratio of 2:1

111
Q

What blood tests are seen in an individual with alcoholic liver disease?

A

Increased ALT + Increased AST with an AST/ALT ratio of 2:1W

112
Q

What is the most common bacteria causing COPD exacerbations?

A

Moraxella Cararrhalis, Haemophilus influenzae and Streptococcus pneumoniae

113
Q

What is the BMI of an obese individual?

A

30-34.9

114
Q

What is the Jarman index?

A

This is used to quantify ‘deprived’ areas. It has now been replaced by the Carr-Hill formula

115
Q

What is the Carr-Hill allocation formula used for?

A

Used to adjust the global sum total for a number of local demographic and other factors which may affect practice work load

116
Q

What is the Carr-Hill allocation formula used for?

A

Used to adjust the global sum total for a number of local demographic and other factors which may affect practice work load

117
Q

What is the first line management of pericarditis?

A

NSAIDs

118
Q

What is the management for Wolff-Parkinson-White syndrome?

A

Ablation of the accessory pathway

119
Q

What thyroid disease is often preceded by a viral infection and what is the treatment?

A

De Quervain’s thyroiditis. Treatment is symptomatic and there is usually no role for antithyroid medications

120
Q

What is the appropriate screening test for Cushing’s Syndrome?

A

24- hour urinary free cortisol measurement

121
Q

What is the medical management of acute limb ischaemia?

A

High flow oxygen and initiation of an unfractionated heparin infusion

122
Q

What are the criteria for longterm oxygen therapy in COPD?

A

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
Q

What is the treatment for Salmonella?

A

Ciprofloxacin

124
Q

What will Legionella Pneumophilia look like on blood results?

A
125
Q

What do you prescribe for HTN when ACEi and CCB aren’t controlling BP?

A

A thiazide-like diuretic such as Indapamide

126
Q

What do you do when a patient’s BP is not controlled by ACEi+CCB+Thiazide-like diuretic?

A

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
Q

What is the first-line rate control in AF?

A

Bisoprolol or a rate limiting CCB

128
Q

When would you immediately start alendronic acid without doing a DEXA scan?

A

If >65 and on long-term steroids

129
Q

What is the first line treatment for Non-bullous localised Impetigo?

A

Hydrogen peroxide 1% cream
For individuals who are systemically well

130
Q

What do you use in widespread non-bullous impetigo?

A

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
Q

What antibiotic should you use for Bullous impetigo for patients who are systemically unwell?

A

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
Q

What is the Glasgow-Blatchford risk score used for?

A

Upper GI Bleed

133
Q

What is the PERC risk score used for?

A

Pulmonary embolisms

134
Q

When is the screening programme for AAA in UK?

A

All men in England are offered a screening ultrasound scan at age 65 to detect asymptomatic AAA.

135
Q

What is Buerger’s test used for?

A

Peripheral arterial disease

136
Q

BNP of what level requires urgent specialist referral for echocardiogram (within 2 weeks)?

A

Levels >2,000ng/L

137
Q

BNP of what level requires specialist referral for ECHO within 6 weeks?

A

400-2,000ng/L

Phase 3a Medicine🩺 (12 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions