GP Flashcards
Sildenafil and T2DM contraindication
Isosorbide mononitrate
Which heart drug often causes rash and itching
Aspirin often causes urticaria
Scoring system for tonsillitis
FeverPAIN
History of fever
Pus
Attends rapidly (3 days)
Inflamed lymph nodes
No cough
2-3 points consider delayed prescription
4+ points consider Abx
Tonsillitis Mx
Pen-v if bacterial (phenoxymethylpenecillin)
Viral if none
How do you discern between venous nad arterial ulcers
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
Whooping cough which Abx
Azithromycin or clarithromycin if onset <21 days
How to distinguish between labyrinthitis and vestibular neuronitis
Hearing is unaffected in vestibular neuronitis
Often affected in labyrinthitis
How to discern between drug induced and idiopathhic Parkinson’s
Drug induced is bilateral
Idiopathic is normally unilateral
Which skin infection starts with a herald patch
Pityriasis rosea
Raynauds first line tx
Lifestyle (hands warm stop smoking) and nifedipine
Which diuretic can cause gynaecomastia
Spironolactone
Shingles Mx
Give oral acyclovir if presenting <72 hours
If not analgesia and ?fusidic acid
C-peptide levels which type of diabetes
If C-peptide levels are low it is t1
- indicates absence of insuli
4 things that can cause falsely high HBA1C
Splenectomy
IDA
B12 deficiency
Alcoholism
Sickle-cell and other haemoglobinopathies can cause low HBA1C levels
Which Abx cause long QT interval
Macrolides e.g. clarithromycin
Which antifungal in nail infection
Terbinafine
What do you add to a beta blocker i angina isn’t controlled
Amlodipine
Don’t add verapamil as it can cause complete heart block
What type of drug is first line in BPH
Alpha-1 antagonists e.g. tamsulosin
5 alpha-reductase inhibitor can be used when monotherapy is inappropriate e.g. finasteride
How to manage stable angina
Beta blocker or CCB (diltiazem not amlodipine)
Also give sublingual GTN spray for acute episodes
How to manage bad acne in primary care
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
What do you do for people with anaemia caused by CKD
Administer EPO
BUT FIRST check iron studies as if iron is deficient as well then there’s no point giving them EPO (?)
Who do you not confirm UTI with a urine dip for
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
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
If not immunocompromised offer varicella vaccination?
If they are give varicella zoster immunoglobulin
How to manage persistent rosacea
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
