GP Flashcards
31-year-old pregnant
facial droop on the left side
denies any other weakness, numbness or tingling in her face or limbs.
All other cranial nerves are intact.
have left-sided hyperacusis and post-auricular tenderness.
The facial droop is the whole left side of her face, including her forehead.
The sensation is intact. Upper and lower limb sensory and motor neurological exam is unremarkable.
Examination of the external auditory meatus is unremarkable bilaterally.
She has no past medical history.
What is the most appropriate management?
Prednisolone 1 mg/kg for 10 days
This patient has a Bell’s palsy - a unilateral idiopathic lower motor neurone facial nerve palsy. She also has associated symptoms such as post-auricular pain and hyperacusis. Pregnancy is a risk factor for Bell’s palsy.
cx by swelling of nerve
Correct. This patient is likely experiencing Bell’s palsy, which is caused by a LMN lesion. LMN lesions cause ipsilateral manifestations, so the left sided symptoms are due to a left sided lesion. The whole side of the face is affected (not forehead sparing), which further indicates a LMN lesion.
who can take oestrogen only HRT
women without uterus as no chance of endometrial cancer
headahces triggered by coughing could be indicative of what
raised ICP - need CT to identify cause
headahces triggered by coughing could be indicative of what
raised ICP - need CT to identify cause
eye pain worse at night
scleritis
what skin codnion affecting the vulva predominently in postmenopaual women
asoosicated with urinary incontinence, as in this woman and increases the risk of vulval malignancy.
lichen sclerosus
how to work out untis of alcohol per week Number of units of alcohol in drink = total volume of a drink (ml) x ABV (%)/1000.
Therefore this patient has (750 ml x 5 bottles) x 13%/1000
= 3750 ml x 13% /1000 = 48.75 units per week
what is recommended
14 units max
gastroenteritis what common cause with short incubation period
Correct. This patient is presenting with symptoms of gastroenteritis following a meal 5 hours ago. The short incubation period and history of the type of meal he had (containing cream and meat) should make you think of Staphylococcus aureus which has a short incubation period (1-6h) and presents with profuse vomiting and watery diarrhoea.
why is nitrofurantoin CI in last trimester
riks of haemoyltic disease of newborn so give amox
how do you check for stones in the salivary glands
by sialogram
how do you check for stones in the salivary glands
by sialogram
. A yellowish, pedunculated sac can be visualised within the right nasal cavity what is this describing
a nasal polyp - high risk of nasocarcinoma so2ww
microcytic anaemia of unknown cause you have basic blood reuslts what you should you do
Haematinics
these might include:
Folate
B12
Ferritin:
Total iron binding capacity (TIBC)
In iron deficiency anaemia, total iron binding capacity will be high and ferritin will be low as the body mobilises available iron stores due to iron deficiency.
what is frist line for angina
GTN AND beta-blocker or rate-limiting calcium channel blocker
1st 2nd and 3rd line for angina investigations
1st line investigations
CT coronary angiography is indicated for atypical or typical angina pain or if ECG shows ischaemic changes in chest pain with <2 angina features.
Functional imaging can be used if CTCA is inconclusive.
2nd line investigations
Myocardial perfusion SPECT
Stress ECHO
MRI for regional wall motion abnormalities
3rd line investigations
Coronary angiogram can be performed if there are inconclusive results from non-invasive testing.
