GP

Question 1

how often is breast screening?

Answer 1

every 3 years

Question 2

In what age range is bowel screening offered?

Answer 2

54-74 years

Question 3

How often is bowel screening done?

Answer 3

every 2 years

Question 4

what are 4 screening tests in pregnancy?

Answer 4

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

Question 5

what are 3 new born screening tests?

Answer 5

NIPE
hearing test
blood spot heel prick test

Question 6

when do you offer Abx in acute bronchitis?

Answer 6

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

Question 7

what is the first line abx in acute bronchitis?

Answer 7

doxycycline

not in preggos or children - Amoxacillin

Question 8

what is a Meibomian cyst?

Answer 8

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

Question 9

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

Answer 9

oral acyclovir and chlorohexadine mouth wash

Question 10

what is the management for genital herpes?

Answer 10

acyclovir

Question 11

what is the management of herpes in pregnancy?

Answer 11

elective c-section if primary genital infection >28 weeks

Question 12

which herpes virus is most commonly responsible for herpes encephalitis?

Answer 12

HSV-1

Question 13

How often do diabetics get their HbA1c measured?

Answer 13

every 3-6 months

Question 14

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

Answer 14

acanthosis nigricans

Question 15

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

Answer 15

SGLT-2 inhibitor - dapagliflozin

Question 16

what is the MOA of metformin?

Answer 16

increases insulin sensitivity and decreases glucose production - a biguanide

Question 17

what are 2 side effects of metformin?

Answer 17

GI symptoms
Lactic acidosis - secondary to AKI

NOT hypos NOT weight gain

Question 18

what is the MOA of SGLT-2 inhibitors?

Answer 18

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

Question 19

what are 8 side effects of SGLT-2 inhibitors?

Answer 19

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

Question 20

what are 4 side effects of pioglitazone?

Answer 20

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

Question 21

what are 2 side effects of sulfonylureas?

Answer 21

weight gain
hypoglycaemia

Question 22

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

Answer 22

Novorapid - works after 10 mins for 4 hours

Question 23

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

Answer 23

Actrapid - works after 30 mins for 8 hours

Question 24

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

Answer 24

Humulin I - works after 1 hour for 16 hours

Question 25

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

Answer 25

Levemir and lantus - works after 1 hour for 24 hours

Question 26

what is the 1st line antihypertensive in T2Dm?

Answer 26

acei

Question 27

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

Answer 27

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.

Question 28

what is the management of pericarditis?

Answer 28

NSAIDs

Question 29

what is the MOA of N-acetylcysteine?

Answer 29

Replenishes body stores of glutathione preventing hepatocyte damage.

Question 30

what is the moa of methotrexate?

Answer 30

competitively inhibits dihydrofolate reductase

Question 31

what is the chronic management for ACS?

Answer 31

Block An ACS Beta Blocker + ACEi + Aspirin + Clopidogrel + Statin

Question 32

what is the MOA of aspirin?

Answer 32

Cox-1 inhibitor

Question 33

what is the MOA of clopidogrel?

Answer 33

P2Y12 inhibitor

Question 34

what is severe asthma in adults?

Answer 34

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

Question 35

what is life threatening asthma in adults?

Answer 35

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

Question 36

what is chronic suppurative ottitis media?

Answer 36

otitis media >2 weeks with recurrent ear discharge

Question 37

what risk score is used for pressure ulcers?

Answer 37

Waterlow score

Question 38

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?

Answer 38

Chvostek sign

Question 39

what is examination finding in otitis media with effusions?

Answer 39

grey tympanic membrane fluid level loss of cone of light reflex AKA glue ear

Question 40

what is examination findings in suppurative otitis media?

Answer 40

mucopurulent discharging ear

Question 41

where does the VZV lay dormant?

Answer 41

dorsal root or cranial nerve ganglia

Question 42

what are 3 risk factors for shingles?

Answer 42

increased age HIV Immunocompromised

Question 43

What are the most commonly affected dermatomes in shingles?

Answer 43

T1-L2

Question 44

what is the presentation of shingles?

Answer 44

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

Question 45

what is the management of shingles?

Answer 45

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

Question 46

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

Answer 46

reduces incidence of post-herpetic neuralgia

Question 47

what are 3 complications of shingles?

Answer 47

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

Question 48

what kind of vaccine is the chickenpox vaccine?

Answer 48

live attenuated

Question 49

when are people given the 'shingle vaccine'?

Answer 49

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

Question 50

what deaths are alway referred to the coroner?

Answer 50

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

Question 51

what is the role of the medical examiner?

Answer 51

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

Question 52

what is 1a on the death certificate?

Answer 52

disease of condition leading directly to death

Question 53

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

Answer 53

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

Question 54

what is part 2 on the death certificate?

Answer 54

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

Question 55

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

Answer 55

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