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Phase 4 > GP > Flashcards

GP Flashcards

1
Q

how often is breast screening?

A

every 3 years

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2
Q

In what age range is bowel screening offered?

A

60-74 years

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3
Q

How often is bowel screening done?

A

every 2 years

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4
Q

what are 4 screening tests in pregnancy?

A

Hep B, HIV and syphilis screen
Down’s, pataus and edwards screen - combined/quadruple test
sickle cell/thallsaemia test
20 week anomaly scan
diabetic eye screen - if have diabetes

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5
Q

what are 3 new born screening tests?

A

NIPE
hearing test
blood spot heel prick test

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6
Q

when do you offer Abx in acute bronchitis?

A

if CRP >20 offer delayed prescription
if CRP >100 offer ABx now

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7
Q

what is the first line abx in acute bronchitis?

A

doxycycline

not in preggos or children - Amoxacillin

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8
Q

what is a Meibomian cyst?

A

internal infection of meibomian glands in eyelid causing lump - like what dan had - hot compress and analgesia should go away on own

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9
Q

what is the management for gingivostomatitis (ulcers) in HSV?

A

oral acyclovir and chlorohexadine mouth wash

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10
Q

what is the management for genital herpes?

A

acyclovir

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11
Q

what is the management of herpes in pregnancy?

A

elective c-section if primary genital infection >28 weeks

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12
Q

which herpes virus is most commonly responsible for herpes encephalitis?

A

HSV-1

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13
Q

How often do diabetics get their HbA1c measured?

A

every 3-6 months

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14
Q

what is the name of the darkening skin on neck axilla and groin seen in insulin resistance?

A

acanthosis nigricans

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15
Q

what medication can be added to patients on metformin with an existing CVD or QRisk >10%?

A

SGLT-2 inhibitor - dapagliflozin

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16
Q

what is the MOA of metformin?

A

increases insulin sensitivity and decreases glucose production - a biguanide

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17
Q

what are 2 side effects of metformin?

A

GI symptoms
Lactic acidosis - secondary to AKI

NOT hypos NOT weight gain

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18
Q

what is the MOA of SGLT-2 inhibitors?

A

prevent sodium glucose co-transporter 2 protein from reabsorbing glucose in proximal tubules allowing for greater excretion

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19
Q

what are 8 side effects of SGLT-2 inhibitors?

A

Glycosuria
Increased urinary output and frequency
UTIs + genital infections
weight loss
DKA
Lower limb amputation
Fourniers gangrene
Hypoglycaemia

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20
Q

what are 4 side effects of pioglitazone?

A

weight gain
heart failure
increased risk bone fractures
small increase risk bladder cancer

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21
Q

what are 2 side effects of sulfonylureas?

A

weight gain
hypoglycaemia

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22
Q

what is a rapid acting insulin and how long does it work for?

A

Novorapid - works after 10 mins for 4 hours

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23
Q

what is a short acting insulin and how long does it work for?

A

Actrapid - works after 30 mins for 8 hours

24
Q

what is an intermediate acting insulin and how long does it work for?

A

Humulin I - works after 1 hour for 16 hours

25
Q

what is a long acting insulin and how long does it work for?

A

Levemir and lantus - works after 1 hour for 24 hours

26
Q

what is the 1st line antihypertensive in T2Dm?

A

acei

27
Q

what are 4 signs of PE? (CXR and ECG)

A

Fleischner sign = dilated central pulmonary vessel. Westermark sign (collapse of vasculature distal to PE) Hampton’s hump - wedge-shaped infarct
ECG features - sinus tachycardia and/or ST depression.

28
Q

what is the management of pericarditis?

A

NSAIDs

29
Q

what is the MOA of N-acetylcysteine?

A

Replenishes body stores of glutathione preventing hepatocyte damage.

30
Q

what is the moa of methotrexate?

A

competitively inhibits dihydrofolate reductase

31
Q

what is the chronic management for ACS?

A

Block An ACS

Beta Blocker + ACEi + Aspirin + Clopidogrel + Statin

32
Q

what is the MOA of aspirin?

A

Cox-1 inhibitor

33
Q

what is the MOA of clopidogrel?

A

P2Y12 inhibitor

34
Q

what is severe asthma in adults?

A

PEF 33–50% best or predicted
RR ≥25/min
HR ≥110/min
inability to complete sentences

35
Q

what is life threatening asthma in adults?

A

PEF <33% best or predicted
SpO2 <92%
PaO2 <8 kPa
‘normal’ PaCO2 (4.6–6.0 kPa)
altered conscious level
exhaustion
arrhythmia
hypotension
cyanosis
silent chest
poor respiratory effort

36
Q

what is chronic suppurative ottitis media?

A

otitis media >2 weeks with recurrent ear discharge

37
Q

what risk score is used for pressure ulcers?

A

Waterlow score

38
Q

what is the name of the sign where muscle twitching is elicited in the face by tapping in front of the ear which is indicative of hypocalcaemia?

A

Chvostek sign

39
Q

what is examination finding in otitis media with effusions?

A

grey tympanic membrane
fluid level
loss of cone of light reflex

AKA glue ear

40
Q

what is examination findings in suppurative otitis media?

A

mucopurulent discharging ear

41
Q

where does the VZV lay dormant?

A

dorsal root or cranial nerve ganglia

42
Q

what are 3 risk factors for shingles?

A

increased age
HIV
Immunocompromised

43
Q

What are the most commonly affected dermatomes in shingles?

A

T1-L2

44
Q

what is the presentation of shingles?

A

prodromal period of burning pain over dermatome for 2-3 days, headache, fever, lethargy

rash - erythematous, macular rash over affected dermatome, becomes vesicular, well demarcated to dermatome

45
Q

what is the management of shingles?

A

Infectious for 5-7 days - until vesicles have crusted
1 - Paracetamol and nsaid analgesia
2 - Neuropathic agents
3 - Oral corticosteroids - if pain is severe and not responding

Aciclovir/famiciclovir/valaciclovir within 72h unless patient <50 years and mild rash, mild pain and no risk factors

46
Q

what is one of the benefits of prescribing antivirals in shingles?

A

reduces incidence of post-herpetic neuralgia

47
Q

what are 3 complications of shingles?

A

Post-herpetic neuralgia - most common
HZ ophthalmicus - affecting occular division of TJN
HZ oticus - ramsay hunt syndrome

48
Q

what kind of vaccine is the chickenpox vaccine?

A

live attenuated

49
Q

when are people given the ‘shingle vaccine’?

A

aged 70-79
live attenuated - contraindicated in immunosuppression
give SC

50
Q

what deaths are alway referred to the coroner?

A

Sudden on unexpected death, or within 24h of hospital admission
Unnatural causes - accidents, suicides, violence, trauma
Unclear/disputed cause
Death shortly after/during medical procedures
Death related to neglect or self-neglect
death in custody/state detention
occupational or industrial diseases

51
Q

what is the role of the medical examiner?

A

independently review clinical record of deceased and discuss circumstances of death with certifying doctor

communicate with family to explain cause of death and address concerns

referral to coroners

52
Q

what is 1a on the death certificate?

A

disease of condition leading directly to death

53
Q

what is 1b/c/d on the death certificate?

A

other disease or condition leading to 1a/1b/1c

54
Q

what is part 2 on the death certificate?

A

other significant conditions contributing to death but not relating to disease or condition causing it

55
Q

when can frailty of old age be used as a cause of death?

A

Patient is >80
personally cared for patient over long time - several months
Observed gradual decline in general health and functioning
Not aware of any identifiable disease or injury that contributed to death
Certain no reason the death should be reported to the coroner

Phase 4 (22 decks)

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