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UKMLA passmed > GP > Flashcards

GP Flashcards

1
Q

The following as red flag symptoms and signs suggesting a serious underlying cause in the case of trigeminal neuralgia:

A
  • Sensory changes
  • Deafness or other ear problems
  • History of skin or oral lesions that could spread perineurally
  • Pain only in the ophthalmic division of the trigeminal nerve (eye socket, forehead, and nose), or bilaterally
  • Optic neuritis
  • A family history of multiple sclerosis
  • Age of onset before 40 years
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2
Q

Chickenpox is a risk factor for (organism name?).. soft tissue infections including…

A

Chickenpox is a risk factor for invasive group A streptococcal soft tissue infections including necrotizing fasciitis

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3
Q

urticaria management

A
  • non-sedating antihistamines (e.g. loratadine or cetirizine) are first-line
    for up to 6 weeks following an episode of acute urticaria
  • a sedating antihistamine (e.g. chlorphenamine) may be considered for night-time use (in addition to day-time non-sedating antihistamine) for troublesome sleep symptoms
  • prednisolone is used for severe or resistant episodes in addition to antihistamines
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4
Q

which T1DM patients should receive metformin?

A

Patients with type I diabetes and a BMI > 25 should be considered for metformin in addition to insulin

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5
Q

most important cause of ventricular tachycardia (VT) clinically

A

Hypokalemia is the most important cause of ventricular tachycardia (VT) clinically, followed by hypomagnesaemia.

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6
Q

organism responsible for syphillis and the two first stages of syphillis presentation

A

** Treponema pallidum**.

  • primary stage of syphilis often manifests as a painless genital ulcer (chancre) and regional lymphadenopathy.
  • If untreated, it progresses to secondary syphilis which typically manifests as a widespread maculopapular rash that includes the palms and soles, along with mucous membrane lesions such as mouth ulcers.
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7
Q

Scalp psoriasis - first-line treatment is

A

Scalp psoriasis - first-line treatment is topical potent corticosteroids

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8
Q

single most important blood test to assess a patient’s response to treatment with levothyroxine for Hashimoto’s thyroiditis.

A

TSH

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9
Q

the investigation of choice for varicose veins/chronic venous disease

A

Venous duplex ultrasound is the investigation of choice for varicose veins/chronic venous disease - it will show retrograde venous flow

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10
Q

Trichomonas vaginalis - treat with

A

oral metronidazole

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11
Q

After smoking cessation,…. is one of the few interventions that has been shown to improve survival in COPD.

A

After smoking cessation, long-term oxygen therapy (LTOT) is one of the few interventions that has been shown to improve survival in COPD.

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12
Q

Antibiotics should be prescribed for acute otitis media immediately if:

A
  • Symptoms lasting more than 4 days or not improving
  • Systemically unwell but not requiring admission
  • Immunocompromise or high risk of complications secondary to significant heart, lung, kidney, liver, or neuromuscular disease
  • Younger than 2 years with bilateral otitis media
  • Otitis media with perforation and/or discharge in the canal

If an antibiotic is given, a 5-7 day course of amoxicillin is first-line. In patients with penicillin allergy, erythromycin or clarithromycin should be given.

Parents should be advised to seek medical help if the symptoms worsen or do not improve after 3 days.

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13
Q

NICE recommend immediate referral for bronchiolotis (usually by 999 ambulance) if they have any of the following:

A
  • apnoea (observed or reported)
  • child looks seriously unwell to a healthcare professional
  • severe respiratory distress, for example grunting, marked chest recession, or a respiratory rate of over 70 breaths/minute
  • central cyanosis
  • persistent oxygen saturation of less than 92% when breathing air.
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14
Q

NICE recommend that clinicians ‘consider’ referring bronchiolitis to hospital if any of the following apply:

A

a respiratory rate of over 60 breaths/minute
difficulty with breastfeeding or inadequate oral fluid intake (50-75% of usual volume ‘taking account of risk factors and using clinical judgement’)
clinical dehydration.

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15
Q

Unilateral glue ear in an adult needs evaluation for a

A

posterior nasal space tumour

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16
Q

Bell’s palsy treatment

A

prednisolone and lubricating eye drops

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17
Q

Subacute thyroditis definition/presentation

A

(also known as De Quervain’s thyroiditis and subacute granulomatous thyroiditis) is thought to occur following viral infection and typically presents with hyperthyroidism.

18
Q

4 phases of subacute thyroditis

A
  • phase 1 (lasts 3-6 weeks): hyperthyroidism, painful goitre, raised ESR
  • phase 2 (1-3 weeks): euthyroid
  • phase 3 (weeks - months): hypothyroidism
  • phase 4: thyroid structure and function goes back to normal
19
Q

investigations in subacute thyroditis

A

thyroid scintigraphy: globally reduced uptake of iodine-131

20
Q

treatment of subacute thyroditis

A
  • usually self-limiting - most patients do not require treatment
  • thyroid pain may respond to aspirin or other NSAIDs
  • in more severe cases steroids are used, particularly if hypothyroidism develops
21
Q

Acute and prophylactic treatment of migraines

A
  • acute: triptan + NSAID or triptan + paracetamol
  • prophylaxis: topiramate or propranolol
22
Q

Acute heart failure with hypotension: which medication can be considered and who qualifies?

A

Acute heart failure with hypotension - inotropes be considered for patients with severe left ventricular dysfunction who have potentially reversible cardiogenic shock

23
Q

how to diagnose occupational asthma

A

Serial peak flow measurements at work and at home are used to detect occupational asthma

24
Q

Pain on longitudinal compression of the thumb is a sign of

A

scaphoid fracture

25
Q

First line treatment for early Lyme disease is

A

14-21 day course of oral doxycycline

26
Q

All patients with peripheral arterial disease should take

A

clopidogrel and atorvastatin

27
Q

3 classic features of reactive arthritis

A

Urethritis + arthritis +/- conjunctivitis = reactive arthritis

28
Q

first-line investigation in suspected prostate cancer

A

Multiparametric MRI has replaced TRUS biopsy as the first-line investigation in suspected prostate cancer

29
Q

treatement of asymptomatic bacteria in catheterised patients

A

Do not treat asymptomatic bacteria in catheterised patients

30
Q

Reactive arthritis definiton and triad of clnical signs

A
  • HLA-B27 associated seronegative spondyloarthropathy.
  • triad of symptoms: arthritis, conjunctivitis and urethritis will be seen.
  • following a diarrhoeal illness or sexually transmitted disease
  • No organism growth on gram stain
  • ‘Can’t see, pee or climb a tree’
31
Q

how to distinguish pseudogout from gout

A

chondrocalcinosis. This can be seen as linear calcifications of the meniscus and articular cartilage on an x-ray of the knee

32
Q

Joint aspiration in pseudogout:

A

Joint aspiration: weakly-positively birefringent rhomboid-shaped crystals

33
Q

how to assess for diabetic neuropathy in the feet

A

A 10 g monofilament should be used to assess for diabetic neuropathy in the feet

34
Q

Send an MSU for all women with a suspected UTI if

A

Send an MSU for all women with a suspected UTI if associated with visible or non-visible haematuria

35
Q

Alzheimer’s disease CT head findings

A

Alzheimer’s disease causes widespread cerebral atrophy mainly involving the cortex and hippocampus

36
Q

if chadvasc score is 0 how do you proceed with anticoag for AF?

A

if chadvasc score 0 arrange transthoracic echo to exclude valvular disease always

37
Q

The management for a child with a first presentation of otitis media with effusion

A

The management for a child with a first presentation of otitis media with effusion is active observation for 3 months - no intervention is required

38
Q

asymptomatic bacteuremia management in pregnancy

A
  • 7 day antibiotic prescription:
    of either nitrofurantoin (should be avoided near term), amoxicillin or cefalexin.
  • urine culture for test of cure
39
Q

common cause of bacterial otitis media

A

viral upper respiratory tract infections (URTIs) typically precede otitis media, but most infections are secondary to bacteria, particularly Streptococcus pneumonaie, Haemophilus influenzae and Moraxella catarrhalis

40
Q

how to switching from fluoxetine to another SSRI

A

Switching from fluoxetine to another SSRI - withdraw then leave a gap of 4-7 days (as it has a long half-life) before starting a low dose of the alternative SSRI

UKMLA passmed (23 decks)

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