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Phase 3a > GP > Flashcards

GP Flashcards

1
Q

Summarise ABCDE for malignant melanoma

A
  1. Asymmetry of lesion
  2. Border irregularity
  3. Colour variegation
  4. Diameter >6mm
  5. Elevation/evolution over time
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2
Q

Summarise alcohol units

A
  1. 14 units/week
  2. Units = (ABVxmL)/1000
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3
Q

Summarise Ix of asthma

A
  1. FeNO testing - to confirm eosinophilic airway inflammation
  2. Spirometry - offered to all > 5y to confirm airway obstruction (FEV1/FVC <70%)
  3. Bronchodilator reversibility
    • If FEV1 improvement by 12% or more = +ve
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4
Q

Summarise cellulitis

A
  1. Bact. infection affecting dermis and subcutaneous tissue
  2. Strep and/or Staph
  3. Sx include:
    • Erythema
    • Calor (hot)
    • Swelling
    • Poorly demarcated margins
  4. Tx: Abx (Fluclox/Macrolides)
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5
Q

Define COPD

A
  1. Emphysema
    • Alveolar wall destruction -> enlargement of distal airspaces
  2. Chronic bronchitis
    • Persistent/recurrent productive cough due to mucus hypersecretion
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6
Q

Sx of COPD

A

Symptoms
1. SoB worsened with exertion
2. Reduced exercise tolerance
3. Chronic productive cough
4. Wheeze
5. Recurrent LRTI
Signs
1. Wheeze/crackle on ausc.
2. Accessory muscle usage
3. Pursed lip breathing
4. Cyanosis

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7
Q

Ix of COPD

A
  1. Spirometry - FEv1/FVC <0.7
  2. FBC
    • Checking for polycythaemia from chronic hypoxaemia
  3. CXR
    • Hyperinflation of chest
    • Flattening of hemidiaphragms and bullae
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8
Q

Tx of COPD

A
  1. Smoking cessation
  2. Annual influenza + one off pneumococcal
  3. SABA (salbutamol) or SAMA (ipratropium) inhaler
  4. LTOT IF:
    • O2 sats <92%
    • FEV1 <30%
    • Polycythaemia
    • Raised JVP or peripheral oedema (cor pulmonale)
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9
Q

Summarise Coeliac disease

A
  1. T cell mediated autoimmune
  2. Small bowel damage + malabsorption
  3. Sx include:
    • N+D+V
    • Abdo pain
    • Systemic Sx (fatigue, wL)
  4. Dx:
    • OGD + biopsy
    • Anti-TTG IgA antibody measurement
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10
Q

Summarise COCP

A
  1. Oestrogen + progestogen
  2. Inhibit ovulation
  3. Thicken cervical mucus
  4. Alter endometrium to prevent fertilisation + implantation
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11
Q

State the main contraindications to COCP

A
  1. Pregnancy
  2. SBP >160
  3. Smokes >15 cigarettes/day and >35
  4. IHD
  5. History of stroke
  6. AF
  7. Migraine with aura
  8. Breastfeeding <6w postpartum
  9. Obesity (not absolute risk)
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12
Q

How often is COCP follow up?

A

3m following initial prescription then annually

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13
Q

Missed pill rules for COCP

A
  1. One missed pill
    • Take as soon as possible
    • Take rest of pack as usual
  2. 2 or more missed in W1
    • Take missed pill asap
    • Take rest as usual
    • Use additional contraception next 7d
    • Emergency contraception if unprotected sex
  3. 2 or more missed in W2
    • Take missed pill asap
    • Take rest as usual
    • No emergency contraception needed if W1 done correctly
  4. 2 or more missed in W3
    • No 7 day break between packs
      • No emergency contraception needed if W2 done correctly
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14
Q

Summarise EllaOne

A
  1. Inhibits or delays ovulation
  2. Use within 120h (5d) of unprotected sex
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15
Q

Summarise gout

A
  1. Accumulation of monosodium urate crystals in and around joints (especially big toe)
  2. Dx:
    • Arthrocentesis
    • Synovial fluid analysis
  3. Tx:
    • NSAIDs
    • Colchicine
    • Steroids
    • Allopurinol if more than 2/3 attacks per year
    • Lifestyle changes:
      • Reduce EtOH
      • Reduce purine rich (meat + seafood)
      • Hyperuricaemia meds - Thiazides, loop diuretics
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16
Q

Summarise UTI

A
  1. Bladder infection
  2. Sx include:
    • Urinary frequency
    • Dysuria
    • Urgency
    • Foul smelling urine
    • Suprapubic pain
  3. Ix: Urine dipstick
  4. Tx:
    • Nitrofurantoin
    • Trimethoprim
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17
Q

State a key Ddx for UTIs

A
  1. Pyelonephritis
  2. Presents with more severe Sx
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18
Q

Summarise HF

A
  1. Inability to pump enough blood to meet body’s needs
  2. State classifications:
    • Dysfunction (systolic or diastolic)
    • Onset (acute or chronic)
    • Severity of Sx
  3. LHF or LVF (pulmonary congestion) Sx include:
    • SOB on exertion
    • Orthopnoea (lying flat)
    • Paroxysmal nocturnal dyspnoea
    • Nocturnal cough
    • Fatigue
    • Bibasal fine crackles on ausc.
  4. RHF (venous congestion)
    • Ankle swelling
    • Weight gain
    • Raised JVP
  5. Ix: NT-pro-BNP levels + ECHO
  6. Tx include:
    • Loop diuretics - Furosemide (fluid overload)
    • 1st line: ACEi - Ramipril and Beta-blocker - Bisoprolol
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19
Q

Summarise hyperparathyroidism

A
  1. Hypercalcaemia
    • BONES: painful bones
    • STONES: renal stones
    • GROANS: GI Sx
    • MOANS: neuro effects (lethargy, fatigue)
  2. Primary
    • Ca2+ HIGH
    • Phosphate LOW
    • PTH HIGH/NORMAL
    • Tx: Parathyroidectomy
  3. Secondary
    • Ca2+ LOW/NORMAL
    • Phosphate LOW/HIGH
    • PTH HIGH
    • Vit D + phosphate binder
  4. Tertiary
    • Ca2+ HIGH
    • Phosphate HIGH
    • PTH LOW/NORMAL
    • Calcimimetic
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20
Q

Summarise iron deficiency anaemia

A
  1. Low iron -> diminished RBC -> diminished O2 transport
  2. Sx include:
    • Fatigue
    • Paleness
    • SoB
  3. Consider colorectal malignancy as IDA may result from GI bleed
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21
Q

Summarise lower GI bleed

A
  1. Bleed distal to ligament of Treitz
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22
Q

Summarise otitis externa

A
  1. Pseudomonas and Staph. aureus
  2. Sx:
    • Minimal discharge
    • Itch and pain
  3. Systemic ABx (Fluclox/Macrolides) only for Pt with fever or lymphadenitis
  4. Topical drops for mild to moderate
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23
Q

Summarise pityriasis rosea

A
  1. Preceding Herald’s patch
    • Single large discoid erythematous patch
  2. Widespread rash few days later/ Christmas tree pattern distribution across trunk
  3. Self limiting
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24
Q

Summarise Raynaud’s

A
  1. Vasospasm of small arteries and arterioles
  2. Reduced blood flow to skin
  3. Manifests as cold induced colour change in fingertips
    • Shifting from white to blue to red
  4. Dx = clinical
  5. Tx: Dihydropyridine
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25
Q

Summarise common bact., viral, fungal CAP

A

BACT.
1. Strep. pneumoniae (COPD)
2. Staph. aureus (CF)
3. H. Influenzae
4. Legionella pneumophila (A/C)
VIRAL
1. Influenza A
2. CMV, HSV, VZV
FUNGAL
1. Candida
2. Aspergillus
3. Cryptococcus

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26
Q

Ix for Pneumonia

A
  1. Bloods
  2. Sputum culture
  3. CURB-65
    • Confusion
    • Urea >7
    • RR >30
    • SBP < 90 or DBP <60
    • Age >65y
  4. CXR
27
Q

Tx of pneumonia

A
  1. CURB-65 score: 0/1
    • Home care + oral amox or doxy if allergy)
  2. CURB-65 score: 2
    • Hospital-base care, 7-10d dual antibiotic therapy with amox + macrolide
  3. CURB-65 score: 3
    • Hospital/ITU care + dual Abx therapy: co-amox + macrolide
28
Q

Summarise HAP

A
  1. Pseudomonas
  2. E.Coli
  3. Klebsiella
  4. HAP within 5d
    • co-amox
  5. HAP more than 5d
    • Tazocin
29
Q

Summarise stable angina

A
  1. Chest pain triggered by myocardial ischaemia
  2. Caused by coronary artery disease
  3. Sx include:
    • Exertional chest discomfort
    • Radiate to jaw/neck/arm
    • Alleviated by rest <5mins or GTN spray
  4. Dx:
    • ECG
    • Bloods
    • CT coronary angiogram
  5. Tx:
    • Lifestyle stuff: stop being gross
    • Aspirin 75mg OD and statin 80mg ON
    • GTN spray
    • Anti-anginal: Bisoprolol (beta blocker) or CCB
30
Q

Summarise T2DM

A
  1. Pancreatic beta-cell insufficiency and insulin resistance
  2. Sx include:
    • Hyperglycaemia
    • Polyuria
    • Polydipsia
    • Blurry vision
    • Fatigue
  3. Ix:
    • Random BM >11.1 mmol/L
    • Fasting plasma glucose >7mmol/L
    • 2h glucose tolerance >11.1 mmol/L
    • HbA1c >48 mmol/L
  4. Tx include:
    • Metformin
    • Pioglitazone (when metformin not possible)
31
Q

State the different types of incontinence

A
  1. Stress
    • Intra abdominal pressure -> pee
  2. Urge
  3. Functional
    • Urge to pass urine but unable to
  4. Overflow - leaking
32
Q

State the 3 types of health behaviours

A
  1. Health behaviours (preventive actions)
  2. Illness behaviour (seeking remedies)
  3. Sick role behaviour (actions to recover)
33
Q

State the main types of public health interventions

A
  1. Population-level (immunisation)
  2. Individual-level (patient centred care)
34
Q

State the factors that influence risk perception

A
  1. Lack of personal experience
  2. Belief in preventability
  3. Belief in low likelihood if not experienced
  4. Perception of rarity
35
Q

State the Health Belief Model

A

A behaviour change model where individuals more likely to change if:
1. Believe in susceptibility
2. Severity of consequences
3. Benefit of action
4. Benefits outweigh costs

36
Q

State Theory of Planned Behaviour

A

Behaviour change is:
1. Driven by intention
2. Influenced by attitude
3. Social norms
4. Perceived control

37
Q

State determinants of health

A
  1. Genes
  2. Environment
  3. Lifestyle
  4. Healthcare access
38
Q

How is equity different from equality in healthcare

A
  1. Equity
    • Fair treatment based on individual need
  2. Equality
    • Everyone receives same share regardless of need
39
Q

State the types of health needs

A
  1. Felt need
  2. Expressed need
  3. Normative need (professionally defined)
  4. Comparative need (based on comparisons)
40
Q

State the main approaches to health needs assessment

A
  1. Epidemiological (based on data)
  2. Corporate (stakeholder input)
  3. Comparative (comparing different groups’ needs)
41
Q

State Maxwell’s dimensions of healthcare quality

A
  1. Effectiveness
  2. Efficiency
  3. Equity
  4. Acceptability
  5. Accessibility
  6. Appropriateness
42
Q

State difference between incidence and prevalence in epidemiology

A
  1. Incidence
    • Number of new cases over time
  2. Prevalence
    • Number of existing cases at a given time
43
Q

State Bradford Hill criteria for causality

A
  1. Strength of association
  2. Dose-response
  3. Consistency
  4. Temporality
  5. Reversibility
  6. Biological plausibility
  7. Coherence
  8. Analogy
  9. Specificity
44
Q

State the 3 types of prevention

A
  1. Primary (preventing disease)
  2. Secondary (early detection)
  3. Tertiary (managing disease for quality of life)
45
Q

State prevention paradox

A

Preventive measure may benefit the population overall but offer little benefit to individual participants

46
Q

State common types of epidemiological studies

A
  1. Cohort studies
  2. Case-control studies
  3. Cross-sectional studies
  4. RCT
  5. Ecological studies
  6. Meta-analysis
  7. Systematic review
47
Q

Summarise Fraser Guidelines

A

Determine if minor can consent to medical treatment without parental knowledge

48
Q

What criteria make a disease a public health concern

A
  1. High mortality
  2. High morbidity
  3. Contagiousness
  4. Treatment costs
    5, Availability of effective intervention
49
Q

Summarise Bolam Rule in medical negligence

A

Assesses if a reasonable doctor would have acted similarly in the same situation

50
Q

Summarise Swiss Cheese Model of Error

A
  1. Multiple layers of defence in healthcare can fail
  2. Allowing errors to pass through gaps
51
Q

What are the 3 domains of public health

A
  1. Health improvement (education, housing, employment)
  2. Health protection (immunisation)
  3. Healthcare (clinical effectiveness and governance)
52
Q

What are the Stages of Change model

A
  1. Behaviour change as progression through stages
  2. Potential relapse
  3. And different speed of change
53
Q

State factors that contribute to food behaviours in early life

A
  1. Maternal diet
  2. Breastfeeding
  3. Parenting practices
  4. Age of solid food introduction
  5. Types of food given
54
Q

What are non-organic feeding disorders (NOFED) in young children?

A
  1. Feeding aversion
  2. Food refusal
55
Q

Summarise ‘Unrealistic Optimism’ in health behaviour

A
  1. Belief risk is lower than it is
  2. Leading to continued health damaging behaviours
56
Q

What is confounding in public health research

A
  1. A situation where an external factor associated with both the exposure and the outcome
  2. Affecting results independently of the main exposure
57
Q

Summarise Wilson and Junger’s criteria for screening programs

A
  1. Important condition
  2. Detectable latent stage
  3. Validated and safe test
  4. Cost-effectiveness
  5. Effective treatment options for early detected cases
58
Q

What does the duty of candor entail for HCPs

A
  1. Requirement to be open and honest with Pts
  2. When treatment errors cause or have potential to cause harm or distress
59
Q

State never events in healthcare

A
  1. Serious preventable incidents that should not occur if proper preventive measures in place
60
Q

State common types of bias in epidemiological studies

A
  1. Selection bias
  2. Information bias
  3. Allocation bias
  4. Publication bias
  5. Lead-time bias
  6. Length-time bias
61
Q

State difference between absolute risk and relative risk

A
  1. Absolute
    • Actual risk number
  2. Relative
    • Compare risk between 2 different groups
62
Q

State the types of screening

A
  1. Population-based screening
  2. Opportunistic screening
  3. Communicable disease screening
  4. Pre-employment medicals
  5. Commercially provided screening
63
Q

Summarise Gillick competence

A
  1. Legal standard
  2. Assess if child under 16
  3. Consent to medical treatment
  4. Based on understanding, maturity and capacity

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