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Year 4 Placements > GP > Flashcards

GP Flashcards

1
Q

Measuring eGFR can under estimate renal function in which patient population?

A

Afro-Caribbean’s

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2
Q

What is the gold standard for diagnosing hypertension?

A

ABPM

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3
Q

What is the mechanism of carbocisteine?

A

Reduces sputum viscosity
Note - must be avoided in patients with past or active peptic ulceration

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4
Q

What is the first line antibiotic for a COPD flare?

A

Amoxicillin

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5
Q

What percentage of parotid swellings are benign?

A

80%

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6
Q

What is the first line antibiotic in parotid gland stones?

A

Amoxicillin

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7
Q

What is the management for cervical spondylosis?

A

Pain relief, physio, exercise

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8
Q

Steroid injections increase the risk of what bony side effect?

A

Osteomyelitis or bone thinning
Note we should not give more than 2 steroid injections to a patient due to this risk, consider PRP injection

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9
Q

Tennis elbow involves which part of the elbow?

A

Lateral epicondyle
Note - golfers elbow involves the medial epicondyle

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10
Q

How long should a patient not be taking:
1. Antibiotics
2. PPIs
3. H2 receptor antagonists
Before being checked for H.pylori infection?

A
  1. Antibiotics - 6 weeks
  2. PPIs - 2 weeks
  3. H2 receptor antagonists - 24 hours
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11
Q

Which angina medication can also help with oesophageal spasms?

A

GTN spray

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12
Q

Which finding on ECG is indicative of a previous MI?

A

Q waves
Note that a single Q wave can be normal, and to be considered pathological must be present in an entire territory (anterior/inferior)

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13
Q

Which blood test should be utilised for monitoring ramipril?

A

U&E 1-2 weeks after starting medication, and 1-2 weeks after changing dose

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14
Q

Which 2 blood tests should be used to monitor statins?

A

LFTs & lipid profile

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15
Q

Ramipril can lead to which 2 side effects? Which class of medication would we switch patients experiencing these onto?

A

Cough & sinusitis; change onto ARB’s e.g. candesartan

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16
Q

What is the first line antibiotic for whooping cough?

A

Clarithromycin
(Macrolides - azithromycin, erythromycin, clarithromycin)

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17
Q

What will we hear on auscultation of the chest in a patient with whooping cough?

A

Nothing

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18
Q

Which antibiotic should be given for a UTI in eGFR under 45ml/min/1.73m^2?

A

Trimethoprim

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19
Q

Which method of emergency contraception is C/I in women with asthma?

A

Ullipristal acetate

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20
Q

Methotrexate has a severe haematological drug interaction with which common UTI antibiotic?

A

Trimethoprim

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21
Q

Which drug should be used for migraine prophylaxis where propranolol is contraindicated?

A

Topiramate

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22
Q

A lump in which quadrant of the breast is most likely to be cancerous?

A

Upper lateral

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23
Q

A new breast lump over the age of what should be referred onwards?

A

30

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24
Q

If MSSU shows pus cells but no bacteria growth which further test should be carried out?

A

STI test

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25
Q

What class of drugs can be used in urge incontinence?

A

Anticholinergics
- oxybutynin, solifenacin, mirabegron

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26
Q

In patients with urge incontinence what 2 substances are important to cut out?

A

Caffeine, tobacco

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27
Q

Which combination of antibiotics should be used for dental infections?

A

Amoxicillin + metronidazole (7 days)

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28
Q

A viral or bacterial cough can last up to how many weeks?

A

3 weeks
- advise patients to come back if cough has not subsided after 3 weeks, referral for CXR

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29
Q

Mycophenolate can be used for what?

A

Immunosuppression, typically for renal/heart/liver transplant, or vasculitis

30
Q

How long can a rib fracture take to heal?

A

6-8 weeks

31
Q

Which common painkiller should be avoided in patients taking long term prednisolone?

A

Ibuprofen
- increases risk of GI bleeding

32
Q

Oxygen desaturating on speaking or walking can be a sign of what?

A

Infection

33
Q

Osteoarthritis in which joint is most common in older women?

A

Base of thumb

34
Q

Back pain in which section of the spine is a red flag?

A

Thoracic

35
Q

PMR is initially managed with what medication?

A

3-4 weeks 15mg prednisolone daily

36
Q

Long term oral corticosteroids are associated with what?

A

Osteoporosis

37
Q

PMR patients should be queried about symptoms of what?

A

GCA

38
Q

Name 3 symptoms of GCA

A

Temporal artery tenderness, headache, jaw claudication

39
Q

Osteomalacia is most commonly due to deficiency in what?

A

Vitamin D

40
Q

Osteomalacia leads to high or low levels of:
Calcium, phosphate, vitamin D, PTH, ALP

A

C - low
P - low
Vit D - low
PTH - high
ALP - high

41
Q

Isolated elevated white cell count can be a sign of what malignancy?

A

Chronic lymphocytic leukaemia

42
Q

Blue sclera is a sign of which metabolic bone disease?

A

Osteogenesis imperfecta

43
Q

Irregular bleeding on Nexplanon can be managed with what?

A

A 3 month course of the COCP

44
Q

How long postpartum should we wait before giving the COCP in:
- Non breastfeeding women
- Breastfeeding women

A

Non - 3 weeks
Breastfeeding - 6 weeks

45
Q

Active pelvic inflammatory disease is a contraindication to which methods of contraception?

A

IUD, IUS

46
Q

How long does the progesterone only pill take to become effective?

A

48 hours

47
Q

Which method of contraception is associated with a delayed return to fertility?

A

Depo-provera injection

48
Q

What advice should we give to patients who miss 2 or more contraceptive pills in:
- week 1 of strip
- week 3 of strip

A

Week 1 - take a pill asap, take next at scheduled time, give emergency contraception, use condoms/abstinence for 7 days
Week 3 - take a pill asap, take next at scheduled time, omit pill free week

49
Q

Ullipristal acetate is contraindicated in what?

A

Asthma

50
Q

Levonorgestrel dose for emergency contraception should be doubled in patients with a:
- BMI over?
- Weight in kg over?

A

BMI over 26kg/m^2
Weight over 70kg

51
Q

Which method of contraception is the only one proven to have a link with weight gain?

A

Depo provera

52
Q

Menopausal patients must be amenorrhoeic for how long before not requiring contraception?

A

2 years

53
Q

Which 2 antibiotics most commonly cause cholestasis?

A

Co-amoxiclav and flucloxacillin

54
Q

What medication can be given for pruritus in PBC and PSC?

A

Cholestyramine
(No C/I)

55
Q

Anti mitochondrial antibodies are likely to be positive in what gallbladder condition?

A

Primary biliary cholangitis

56
Q

What is the definitive treatment for primary sclerosing cholangitis?

A

Liver transplant

57
Q

Charcot’s triad encompasses what symptoms?

A

RUQ pain, fever, jaundice

58
Q

Murphy’s sign can be seen in disorders of what organ?

A

Gallbladder

59
Q

What is the gold standard investigation in ascending cholangitis and acute cholecystitis?

A

USS

60
Q

Gallstone pain may be worse after eating a meal rich in what?

A

Fat

61
Q

Asymptomatic gallstones require what treatment?

A

Reassurance and observation

62
Q

Asymptomatic gallstones require what treatment?

A

Reassurance and observation

63
Q

Which UTI antibiotic is unsafe in the third trimester of pregnancy and why?

A

Nitrofurantoin
Can cause haemolytic anaemia of the newborn

64
Q

Which 2 types of laxative should be used in conjunction for opioid induced constipation?

A

Stimulant + osmotic
E.g. senna + macrogol

65
Q

Which bacteria is most likely implicated in cases of spontaneous bacterial peritonitis?

A

E.coli

66
Q

What is the most common lifestyle cause of macrocytosis?

A

Alcohol

67
Q

What scoring system is used for scoring sleep apnoea?

A

Epworth sleepiness scale

68
Q

Asymptomatic isolated raised bilirubin can be a sign of what?

A

Gilbert’s disease

69
Q

What type of alimentary ulceration is most commonly associated with H.pylori?

A

Duodenal (90%)
- gastric ulcers 70-80%

70
Q

Which urge incontinence drug should be used in those with a history of dementia?

A

Mirabegron

71
Q

Which urge incontinence drug should be used in those with a history of dementia?

A

Mirabegron

Year 4 Placements (8 decks)

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