GP Flashcards
What would you cover in a standard T2 diabetes checkup?
Blood glucose testing: This is one of the most important tests for people with type 2 diabetes. The doctor will check the patient’s blood glucose levels to see how well their diabetes is being managed.
HbA1C testing: This is a blood test that measures a person’s average blood glucose level over the past 2-3 months. It provides an overall picture of how well their diabetes is being managed.
Blood pressure testing: High blood pressure is a common complication of diabetes. The doctor will check the patient’s blood pressure to see if it is within a healthy range.
Cholesterol testing: Diabetes can increase the risk of heart disease and stroke, so it is important to check cholesterol levels.
Kidney function testing: Diabetes can damage the kidneys over time. The doctor will check the patient’s kidney function with a blood and urine test.
Foot exam: Diabetes can cause nerve damage in the feet, so the doctor will check for any signs of foot problems.
Eye exam: Diabetes can damage the eyes over time, so the doctor will check for any signs of eye problems.
Diet and exercise counseling: A healthy diet and regular exercise are important for managing type 2 diabetes. The doctor may offer counseling on how to make lifestyle changes to improve diabetes management.
Medication adjustments: Depending on the results of the tests, the doctor may adjust the patient’s medication regimen to help better manage their diabetes.
What are the RACGP guidelines for safe alcohol drinking?
2 standard drinks or less per day, no more than four on any one occasion
What are some recommended preventative activities for infants and young children, as outlined in the RACGP Red Book?
The RACGP Red Book recommends preventative activities for infants and young children such as exclusive breastfeeding for the first 6 months, vitamin D supplementation for breastfed infants, and avoidance of exposure to tobacco smoke.
How often should a child’s height and weight be measured during the first 2 years of life, according to the Red Book?
The RACGP Red Book recommends measuring a child’s height and weight at every visit in the first 2 years of life, and then annually thereafter.
What is the recommended age range for routine screening for vision and hearing in children, according to the Red Book?
The recommended age range for routine screening for vision and hearing in children is between 4-5 years of age, according to the RACGP Red Book.
What are some recommended preventative activities for school-aged children, as outlined in the RACGP Red Book?
The RACGP Red Book recommends preventative activities for school-aged children such as encouraging physical activity, healthy eating habits, and promoting sun protection.
What is the recommended schedule for immunisations in children, according to the Red Book?
The RACGP Red Book provides a recommended schedule for immunisations in children, which includes vaccinations for diseases such as measles, mumps, rubella, pertussis, and hepatitis B, among others
What is the recommended age range for screening for dyslipidaemia in children and adolescents, as outlined in the Red Book?
The RACGP Red Book recommends screening for dyslipidaemia in children and adolescents between the ages of 9-11 years, and again between the ages of 18-21 years.
What is the recommended age for administering the first dose of the hepatitis B vaccine to infants in Australia?
The first dose of the hepatitis B vaccine is recommended to be given within 24 hours of birth, as per the Australian National Immunisation Program (NIP) schedule.
How many doses of the diphtheria-tetanus-pertussis vaccine (DTaP) are recommended for children in the Australian National Immunisation Program schedule?
The NIP schedule recommends five doses of DTaP vaccine to be given at 2, 4, 6, 18 months, and 4 years of age.
At what age should children receive the first dose of the pneumococcal vaccine in Australia?
The first dose of the pneumococcal vaccine is recommended to be given at 6 weeks of age, as per the NIP schedule.
What is the recommended age for administering the first dose of the measles-mumps-rubella (MMR) vaccine in Australia?
The first dose of the MMR vaccine is recommended to be given at 12 months of age, as per the NIP schedule.
What vaccine is recommended for all infants in Australia at 6 weeks of age?
The first dose of the combined diphtheria-tetanus-acellular pertussis-inactivated polio-Haemophilus influenzae type b vaccine (DTPa-IPV-Hib) is recommended for all infants in Australia at 6 weeks of age.
As well as the 1st rotavirus and pneumococcal vaccine.
How many doses of the rotavirus vaccine are recommended for infants in Australia?
The NIP schedule recommends two doses of the rotavirus vaccine to be given at 6 weeks and 4 months of age.
What is the recommended age for administering the human papillomavirus (HPV) vaccine in Australia?
The HPV vaccine is recommended to be given at 12-13 years of age, as per the NIP schedule.
What vaccine is recommended for all children in Australia at 12 months of age?
The NIP schedule recommends the measles-mumps-rubella (MMR) vaccine be given at 12 months of age. As well as the first dose of the meningococcal ACWY and pneumococcal vaccine.
How many doses of the meningococcal ACWY vaccine are recommended for adolescents in Australia?
The NIP schedule recommends one dose of the meningococcal ACWY vaccine for adolescents at 12 months of age and a booster dose at 15 years of age.
What is the recommended age for administering the varicella (chickenpox) vaccine in Australia?
The varicella vaccine is recommended to be given at 18 months of age, as per the NIP schedule, as a part of the MMRV.
What vaccine is recommended for all children in Australia at 4 years of age?
The NIP schedule recommends the diphtheria-tetanus-pertussis vaccine (DTaP) and inactivated polio vaccine (IPV) booster to be given at 4 years of age.
What is the recommended frequency for colorectal cancer screening in middle-aged adults with average risk?
For average-risk adults aged 50-74 years, the RACGP recommends screening for colorectal cancer every two years with fecal occult blood testing (FOBT), or every 10 years with colonoscopy.
What are the recommended screening tests for cervical cancer in middle-aged women with no history of abnormal results?
The RACGP recommends that women aged 25-74 years undergo screening for cervical cancer every five years with a human papillomavirus (HPV) test.
What are the recommended guidelines for blood pressure screening in middle-aged adults?
The RACGP recommends that all adults aged 45 years and older have their blood pressure checked at least once a year.
What are the recommended guidelines for lipid screening in middle-aged adults?
The RACGP recommends that all adults aged 45-49 years have their lipids checked at least once, and those aged 50-74 years have their lipids checked every five years.
What are the recommended guidelines for diabetes screening in middle-aged adults with no history of diabetes?
The RACGP recommends that all adults aged 40-49 years have a diabetes risk assessment at least once, and those aged 50-74 years have their blood glucose levels checked every three years.
What are the recommended guidelines for osteoporosis screening in middle-aged adults?
Review fracture risk factors for women aged >45 years and men aged >50 years.
The RACGP recommends that women aged 50-69 years and men aged 70-74 years have a bone mineral density test at least once.
What are the recommended guidelines for skin cancer screening in middle-aged adults?
The RACGP recommends that all adults perform monthly self-examination for skin cancer and visit a healthcare professional for a full-body skin examination at least every two years.
What are the recommended guidelines for breast cancer screening in middle-aged women?
The RACGP recommends that women aged 50-74 years have a mammogram every two years.
What are the recommended guidelines for prostate cancer screening in middle-aged men?
The RACGP recommends that men aged 50-69 years make an informed decision about prostate cancer screening after discussing the benefits and harms with their healthcare provider.
What are the recommended guidelines for immunizations in middle-aged adults?
The RACGP recommends that middle-aged adults receive recommended immunizations, including influenza vaccine every year, pneumococcal vaccine if indicated, and tetanus-diphtheria-pertussis vaccine every 10 years.
What are the recommended vaccinations for adults aged 65 years and older?
The recommended vaccination schedule for older adults in Australia includes a yearly influenza vaccine, a one-time dose of pneumococcal vaccine (if not previously vaccinated), and a shingles vaccine.
What is the recommended interval between two doses of shingles vaccine?
Answer: The recommended interval between two doses of the shingles vaccine is two to six months.
What is the recommended interval between the pneumococcal vaccine and the previous dose or doses?
Answer: The recommended interval between the pneumococcal vaccine and any previous dose or doses is at least five years.
Can older adults receive the shingles vaccine if they have had shingles before?
Yes, older adults can receive the shingles vaccine even if they have had shingles before, as the vaccine can help prevent future episodes or reduce the severity of symptoms.
Differences between Shingrix and Zostavax.
How do Shingrix and Zostavax differ in their composition?
Answer: Shingrix is a recombinant zoster vaccine that contains a piece of the herpes zoster virus, while Zostavax is a live attenuated vaccine that contains a weakened form of the virus.
Which vaccine is more effective in preventing shingles?
Answer: Shingrix is more effective in preventing shingles compared to Zostavax, with an efficacy rate of over 90% compared to about 50% for Zostavax.
How many doses of Shingrix are required and what is the interval between doses?
Answer: Shingrix requires two doses, with an interval of 2 to 6 months between doses.
How many doses of Zostavax are required and what is the interval between doses?
Answer: Zostavax requires one dose only.
Who can receive Shingrix?
Answer: Shingrix is recommended for adults aged 50 years and older, including those who have previously received Zostavax.
Who can receive Zostavax?
Answer: Zostavax is recommended for adults aged 60 years and older who have not received the shingles vaccine before.
What are some risk factors for falls in older adults?
Some risk factors for falls in older adults include history of falls, muscle weakness, gait and balance disorders, visual impairment, cognitive impairment, polypharmacy, home hazards, and chronic medical conditions such as arthritis, osteoporosis, and stroke.
What are some recommended strategies for preventing falls in older adults?
Some recommended strategies for preventing falls in older adults include exercise programs to improve strength, balance and mobility, medication review and management, vision assessment and correction, home safety assessment and modification, and management of chronic medical conditions.
How can home hazards be addressed to prevent falls?
Home hazards can be addressed by conducting a home safety assessment, which may involve identifying and removing tripping hazards, improving lighting and visibility, installing handrails and grab bars, and using non-slip surfaces and footwear. Simple modifications such as removing clutter, securing loose rugs, and keeping commonly used items within reach can also help reduce the risk of falls.
Who is considered high-risk for falls under the RACGP guidelines
According to the RACGP Red Book guidelines, the following individuals are considered to be at high risk of falls:
- Older adults aged 65 years and older, particularly those who have experienced a fall in the past year
- Individuals with medical conditions that affect balance, mobility, or cognitive function, such as Parkinson’s disease, stroke, dementia, or peripheral neuropathy
- Individuals taking multiple medications, especially those with sedative, hypnotic, or psychotropic effects
- Individuals with visual impairment, particularly those with decreased contrast sensitivity, depth perception, or visual acuity
- Individuals living in environments with hazards that increase the risk of falls, such as uneven surfaces, cluttered spaces, or inadequate lighting.
What are the key risk factors for dementia?
The key risk factors for dementia include age, genetics, cardiovascular risk factors (such as hypertension, diabetes, and hyperlipidemia), head injury, and low educational attainment.
What are the recommended screening tools for cognitive impairment in primary care?
The recommended screening tools for cognitive impairment in primary care include the Mini-Mental State Examination (MMSE) and the Montreal Cognitive Assessment (MoCA).
Screening questions for dementia.
Have you noticed any changes in your memory or thinking abilities?
Have you experienced any difficulty with daily tasks, such as cooking, cleaning, or managing finances?
Have you noticed any changes in your mood or behavior, such as becoming more irritable, anxious, or depressed?
Have you had any recent falls or accidents?
Have you noticed any changes in your sense of direction or ability to navigate familiar places?
Have family members or friends expressed concern about your memory or thinking abilities?
Hep B Vaccination Guidelines.
Infants: The first dose of the hepatitis B vaccine is recommended within the first 24 hours of life, followed by two more doses at 2 and 6 months of age.
Unvaccinated adults: two adult doses
HPV Vaccination Guidelines
Routine HPV vaccination for adolescents: The HPV vaccine is recommended for routine use in both boys and girls at age 12-13 years. The vaccine is given as a 2-dose series with a 6- to 12-month interval between doses. Adolescents who start the vaccine series at age 14 years or older require a 3-dose series.
Catch-up HPV vaccination for older adolescents and young adults: HPV vaccine catch-up programs are available for individuals who missed getting vaccinated during the routine vaccination period. For individuals aged 14-19 years, a 2-dose series with a 6- to 12-month interval between doses is recommended. For individuals aged 20-26 years, a 3-dose series is recommended.
MMR Vaccination Guidelines
Routine MMR vaccination for children: The MMR vaccine is recommended for routine use in children at 12 months of age. A second dose is recommended at 18 months of age or older, typically given at 4 years of age.
Catch-up MMR vaccination for older children and adults: MMR vaccine catch-up programs are available for individuals who missed getting vaccinated during the routine vaccination period. Individuals born during or after 1966 who have not had two documented doses of MMR vaccine, or who do not have evidence of immunity to measles, mumps, and rubella, should receive the MMR vaccine.
What is shown here?
Cholesteatoma
Otoscopic image of the left tympanic membrane.
Encrustation and darkening of the epithelium can be seen in the posterior upper quadrant marginal to the pars flaccida (arrow). The localization and findings indicate a cholesteatoma.
Atopic dermatitis, also called atopic eczema, the most common inflammatory skin disease worldwide, presents as generalised skin dryness, itch, and rash.
Chronic plaque psoriasis
Large, well-demarcated, red, scaly and thickened areas of skin. It is most likely to affect elbows, knees, and lower back but may arise on any part of the body.
Multiple small scaly erythematous lesions are visible.
This appearance is typical of guttate psoriasis and is most often precipitated by group A streptococcal infection.
A scaly, erythematous plaque surrounded by multiple, partly confluent, follicular papules is visible on the skin of the antecubital fossa. Features include lichenification, dry skin, scaling, fissuring, post-inflammatory hyp/hyper pigmentation
This finding is characteristic of chronic eczema
Nail pitting in psoriasis
Multiple, small round depressions are seen in the nails.
Nail pitting and onycholysis are typical features of psoriasis with nail involvement.
Molluscum contagiosum is a common poxvirus skin infection of childhood that causes localised clusters of umbilicated epidermal papules.
This rash on a young adult appeared 2 days after starting amoxicillin for a sore throat . What is the most likely cause of their sore throat ?
The typical exanthem of infectious mononucleosis is an acute, generalised maculopapular rash.
A more intense and extensive cutaneous eruption appears in up to 90% of patients with infectious mononucleosis 2–10 days after starting antibiotics. The rash usually resolves within a week of discontinuing the antibiotic.
This is pityriasis versicolor. It is a benign infection of the skin common in hot/humid climates. Flaky discoloured patches appear on the chest and back.
Pityriasis versicolor is caused by mycelial growth of fungi of the genus Malassezia.
An asymmetric nodule (~1 cm in diameter) with central ulceration, and rolled out edges.
This appearance is typical of nodular basal cell carcinoma.
Basal cell carcinoma
A pearly nodule with central atrophy and peripheral telangiectatic vessels is visible on the front of the nose.
flat, eczematous (scaly) plaque with a pearly border with multiple microerosions.
A plaque with raised borders and crusting is the typical appearance of superficial basal cell carcinoma
Seborrhoeic keratosis
Multiple darkly pigmented papules/plaques, sharply demarcated, and soft
Greasy, wax-like, and “stuck-on” appearance
Seborrhoeic keratosis
Actinic keratosis
The entire hairless portion of the scalp is covered with telangiectasia, light brown papules, and yellow-brownish, hyperkeratotic plaques.
Actinic keratosis
Multiple scaly lesions on erythematous skin are visible.
Cutaneous SCC
SCC
Malignant melanoma
A hyperpigmented, slow-growing lesion can be seen on the medial border of the sole. The lesion is asymmetric, has an irregular border and variable pigmentation, and is ∼8 mm in diameter.
This lesion fulfills the A (asymmetry), B (border irregularity), C (color variegation), D (diameter >6 mm), and E (evolving lesion; increase in size) criteria for diagnosing malignant melanoma. The diagnosis should be confirmed by performing a full-thickness biopsy of the lesion.
Lentigo maligna
A 3-cm large, irregularly pigmented macule with irregular borders and surrounding mottling is visible.
This appearance is suggestive of lentigo maligna. However, dermoscopy should be performed to further assess and classify the lesion.
Healthy tympanic membrane
Acute otitis media:
Note inflammation, bulging of TM and loss of anatomical landmarks
Eczema herpeticum
A vesicular eruption with multiple monomorphic, circular, partially confluent lesions, many of which show central umbilication is seen on the right shoulder of a patient with atopic dermatitis.
Eczema herpeticum is considered a dermatological emergency and treatment with oral or IV acyclovir must be initiated quickly.
Erythema multiforme
Target (bull’s-eye) lesions are located on the lower right arm and hand. The lesions consist of three layers: a blue livid center, pale intermediate zone, and a dark red peripheral rim. Some exhibit central blistering.
Herpes Zoster
