GP Flashcards
POP SE’s
MH
spotting
RFs for suicide
- male
- substance abuse
- isolation
- lower socioeconomic status
- previous attempts
- fam hx
- employment
- relationship breakdown
Mx of acute pulmonary oedema
- Oxygen to get sats up
- furosemide - IV
what is polymylagia rheumatica
SX
MX
- Polymyalgia rheumatica is a systemic inflammatory condition characterised by pain and stiffness of the neck, shoulders and pelvis [large proximal joints].
- stiffness, weight loss, anorexia,
- Mx = steroids: oral prednisolone
HTN stages
- stage 1: >145/90
- Stage 1: Clinic = 140/90; ABPM = 135/85
- Stage 2: Clinic = 160/100; ABPM =150/95
- Stage 3: Clinic SBP = 180 or DBP =120
what causes the MC SE of ACEi’s
ACE inhibitors prevent the breakdown of bradykinin, a substance that can cause a persistent dry cough in some patients
SEs of amlodipine
- gum hypertrophy
- ankle swelling
Graves causes what condition and what serology is seen
- hyperthyroidism
- anti-TPO antibodies
MC cause of hyperthyroidism in pregnancy
Graves disease
what is this
folliculitis
one on right is pustular
T/F
In heart failure you should always titrate a diuretic such as furosemide to the lowest dose possible that controls symptoms.
TRUE
Titrating to the maximum tolerated dose unnecessarily risks side effects and electrolyte imbalances
what drugs can aggravate psoriasis
BALI
- B-blockers,
- Anti-malarials,
- Lithium,
- Indomethacin/NSAIDs
MI vs aortic dissection Sx
- similar Sx of central crushing pain that radiates BUT
- MI pain progresses while aortic dissection is worst at onset
- aortic dissection pain radiates caudally [down the spine] MI doesn’t
- A weak left-sided pulse is seen aortic dissection due to involvement of the subclavian artery.
Fleischner sign =
dilated central pulmonary vessel
pericarditis Mx
NSAIDs are 1st line.
Low-dose colchicine may be given (alone or in combination with an NSAID) for patients with recurrent or continued symptoms beyond 14 days.
heparin reversal agent
- protamine
- works partially for LMWH
- reversal of heparin is not usually needed, as it has a short half-life, but if significant haemorrhage occurs then it may be necessary.
DOAC reversal agent
beriplex
warfarin reversal agent
Warfarin overdose is treated with vitamin K.
If the haemorrhage is significant, they are given beriplex alongside it
what is Idarucizumab used for
reversal of dabigatran
post ACS meds
- Block An ACS
(Beta blocker, ACEi, Aspirin, Clopidogrel, Statin).
infective causes of otitis external
pseudomonas aureginosa
staph aureus
fungal infection [aspegillus or candida]
complication of otitis external
necrotising otitis externa or malignant otitis externa. An invasive form of OE which can progress into:
- osteomyelitis of the temporal bone
- several cranial nerve palsies
-death
otitis external Sx
- pain: ear, jaw, headache. Severe in NOE
- itchiness
- discharge - occluding + preventing otoscope
- hearing loss - conductive
- fever
- facial weakness [NOE]
otitis externa Mx
- analgesia
- mild cases: acetic acid
- moderate -severe: antibiotic ear drops ± steroid drops.
- otomize = neomycin + dexamethasone. MC used.
- some pts with severe or systemic Sx may need oral abx as
- fungal cases: clotirmiazole ear drops
- NOE: admission under ENT for minimum 6 week course of Abx [ceftazidime]
Mx of otitis externa where the ear is very swollen and inflamed
ear wick is used
spong/ gauze with topical abx+steroid is placed in the ear for ~ 48 hrs to bring down local swelling.
- wick is removed then sprays or drops are commenced.
Rfs for necrotising otitis externa
- immunocompromised [chemo]
- HIV
- diabetes
- heads/ neck radiotherapy
a patient presents with gynaecomastia, what additional examination should be performed.
a testicular examination to rule out a Leydig cell testicular tumour.
causes of gynaecomastia
Gynaecomastia can be caused by conditions that increase oestrogen:
- Obesity (aromatase is an enzyme found in adipose tissue that converts androgens to oestrogen)
- Testicular cancer (oestrogen secretion from a Leydig cell tumour)
- Liver cirrhosis and liver failure
- Hyperthyroidism
- Human chorionic gonadotrophin (hCG) secreting tumour, notably small cell lung cancer
