GP

Question 1

Sildenafil and T2DM contraindication

Answer 1

Isosorbide mononitrate

Question 2

Which heart drug often causes rash and itching

Answer 2

Aspirin often causes urticaria

Question 3

Scoring system for tonsillitis

Answer 3

FeverPAIN

History of fever
Pus
Attends rapidly (3 days)
Inflamed lymph nodes
No cough

2-3 points consider delayed prescription
4+ points consider Abx

Question 4

Tonsillitis Mx

Answer 4

Pen-v if bacterial (phenoxymethylpenecillin)
Viral if none

Question 5

How do you discern between venous nad arterial ulcers

Answer 5

Location
Venous= medial malleolus
Arterial= lateral malleolus

Both are painful

Neuropathic are painless

ALSO

Arterial are deep and punched out with well-defined edges

Venous are bigger and shallower

Question 6

Whooping cough which Abx

Answer 6

Azithromycin or clarithromycin if onset <21 days

Question 7

How to distinguish between labyrinthitis and vestibular neuronitis

Answer 7

Hearing is unaffected in vestibular neuronitis

Often affected in labyrinthitis

Question 8

How to discern between drug induced and idiopathhic Parkinson’s

Answer 8

Drug induced is bilateral

Idiopathic is normally unilateral

Question 9

Which skin infection starts with a herald patch

Answer 9

Pityriasis rosea

Question 10

Raynauds first line tx

Answer 10

Lifestyle (hands warm stop smoking) and nifedipine

Question 11

Which diuretic can cause gynaecomastia

Answer 11

Spironolactone

Question 12

Shingles Mx

Answer 12

Give oral acyclovir if presenting <72 hours

If not analgesia and ?fusidic acid

Question 13

C-peptide levels which type of diabetes

Answer 13

If C-peptide levels are low it is t1
- indicates absence of insuli

Question 14

4 things that can cause falsely high HBA1C

Answer 14

Splenectomy
IDA
B12 deficiency
Alcoholism

Sickle-cell and other haemoglobinopathies can cause low HBA1C levels

Question 15

Which Abx cause long QT interval

Answer 15

Macrolides e.g. clarithromycin

Question 16

Which antifungal in nail infection

Answer 16

Terbinafine

Question 17

What do you add to a beta blocker i angina isn’t controlled

Answer 17

Amlodipine

Don’t add verapamil as it can cause complete heart block

Question 18

What type of drug is first line in BPH

Answer 18

Alpha-1 antagonists e.g. tamsulosin

5 alpha-reductase inhibitor can be used when monotherapy is inappropriate e.g. finasteride

Question 19

How to manage stable angina

Answer 19

Beta blocker or CCB (diltiazem not amlodipine)

Also give sublingual GTN spray for acute episodes

Question 20

How to manage bad acne in primary care

Answer 20

Dual therapy with e.g benzoyl peroxide, adapalene, lymecycline, clindamycin etc

GIVE ERYTHROMYCIN IN PREGNANT WOMEN and also stop retinoids e.g. tretinoin

If those don’t work for 12 weeks / there is scarring then refer to dermatology

Question 21

What do you do for people with anaemia caused by CKD

Answer 21

Administer EPO

BUT FIRST check iron studies as if iron is deficient as well then there’s no point giving them EPO (?)

Question 22

Who do you not confirm UTI with a urine dip for

Answer 22

All men
Women over 65
Catheterised patients

Do a urine culture instead

?for men more at risk of atypical pathogens causing UTI so Abx depends on sensitivities

Question 23

How do you manage someone with no chicken pox vaccination if they have been in contact with someone with chicken pox AND if they are immunocomprimised

Answer 23

If not immunocompromised offer varicella vaccination?

If they are give varicella zoster immunoglobulin

Question 24

How to manage persistent rosacea

Answer 24

if high-factor suncream hasn’t worked:

Topical brimonidine gel considered if predominant flushing with less telangiectasia

If lots of papules/ sutures then give topical ivermectin

Question 25

Management of suspected epididymoorchitis when organism unknown

Answer 25

Ceftriaxone IM single dose AND oral doxycycline for 10-14 days