GP

Question 1

Acne Vulgaris

Answer 1

Signs and Symptoms: Comedones (blackheads/whiteheads), papules, pustules, cysts on the face, back, chest.
Investigations: Clinical diagnosis; if severe or persistent, consider hormonal testing (for women), skin swabs for secondary infections.
Management:
Mild: Topical treatments (benzoyl peroxide, topical retinoids).
Moderate: Oral antibiotics (e.g., tetracyclines).
Severe: Oral isotretinoin; hormonal treatments for females.

Question 2

Acute Bronchitis

Answer 2

Signs and Symptoms: Cough (with or without sputum), wheezing, fever, chest discomfort.
Investigations: Usually clinical; chest X-ray if pneumonia suspected.
Management:
Symptomatic treatment (analgesia, hydration, steam inhalation).
Antibiotics are generally not required unless bacterial infection suspected.

Question 3

Acute Stress Reaction

Answer 3

Signs and Symptoms: Anxiety, irritability, intrusive thoughts, sleep disturbances, physical symptoms like palpitations.
Investigations: Clinical diagnosis, rule out other mental health conditions.
Management:
Psychological support (CBT, counseling).
Short-term use of benzodiazepines or SSRIs if necessary.

Question 4

Allergic Disorder

Answer 4

Signs and Symptoms: Itchy eyes, runny nose, sneezing, skin rashes, asthma symptoms.
Investigations: Skin prick test, blood tests (e.g., specific IgE).
Management:
Antihistamines, intranasal corticosteroids.
Allergen avoidance, desensitization (immunotherapy) if necessary.

Question 5

Anaemia

Answer 5

Signs and Symptoms: Fatigue, pallor, dyspnoea, dizziness.
Investigations: Full blood count (FBC), iron studies, B12, folate levels.
Management:
Treat underlying cause (iron supplements, B12 injections).
Transfusion if severe.

Question 6

Anal Fissure

Answer 6

Signs and Symptoms: Pain during defecation, blood streaked stool, itching.
Investigations: Clinical diagnosis, anoscopy if necessary.
Management:
High-fiber diet, increased hydration, stool softeners.
Topical nitrates or diltiazem.
Surgery for chronic cases.

Question 7

Anaphylaxis

Answer 7

Signs and Symptoms: Sudden onset of urticaria, difficulty breathing, hypotension, shock, swelling.
Investigations: Clinical diagnosis, serum tryptase post-episode.
Management:
Immediate intramuscular epinephrine.
Antihistamines and corticosteroids.
Monitor in hospital for 24 hours.

Question 8

Arrhythmias

Answer 8

Signs and Symptoms: Palpitations, dizziness, syncope, chest pain.
Investigations: ECG, Holter monitoring, echocardiogram.
Management:
Rate control with beta-blockers or calcium channel blockers.
Rhythm control with antiarrhythmics or cardioversion.
Catheter ablation in certain cases.

Question 9

Asthma

Answer 9

Signs and Symptoms: Wheezing, shortness of breath, chest tightness, coughing.
Investigations: Spirometry, peak flow measurements, skin prick test for allergies.
Management:
Inhaled bronchodilators (salbutamol), corticosteroids.
Long-term control with inhaled corticosteroids, leukotriene receptor antagonists.
Monitor with peak flow.

Question 10

Atopic Dermatitis and Eczema

Answer 10

Signs and Symptoms: Itchy, dry, inflamed skin, often flexural areas.
Investigations: Clinical diagnosis; patch testing if suspected allergens.
Management:
Topical corticosteroids, emollients.
Antihistamines for itching.
Avoid triggers (e.g., harsh soaps, allergens).

Question 11

Atrophic Vaginitis

Answer 11

Signs and Symptoms: Vaginal dryness, itching, painful intercourse.
Investigations: Clinical diagnosis, pelvic exam.
Management:
Vaginal estrogen therapy.
Lubricants for dryness.

Question 12

Benign Eyelid Disorders

Answer 12

Signs and Symptoms: Swelling, redness, lumps on eyelid.
Investigations: Clinical diagnosis; biopsy if unsure.
Management:
Warm compresses, topical antibiotics for styes.
Excision if persistent lumps.

Question 13

Benign Paroxysmal Positional Vertigo (BPPV)

Answer 13

Signs and Symptoms: Sudden, brief episodes of dizziness triggered by head movement.
Investigations: Dix-Hallpike maneuver, audiometry.
Management:
Epley maneuver (canalith repositioning).
Vestibular rehabilitation exercises.

Question 14

Benign Prostatic Hyperplasia (BPH)

Answer 14

Signs and Symptoms: Urinary hesitancy, weak stream, nocturia.
Investigations: Digital rectal exam, prostate-specific antigen (PSA), ultrasound.
Management:
Alpha-blockers (e.g., tamsulosin), 5-alpha-reductase inhibitors.
Surgery (TURP) if symptoms severe.

Question 15

Bursitis

Answer 15

Signs and Symptoms: Joint pain, swelling, warmth, pain with movement.
Investigations: Clinical diagnosis, joint aspiration for fluid analysis.
Pus -infection
Straw-coloured fluid - infection is less likely
Blood-stained fluid - trauma, infection or inflammatory causes
Milky fluid - gout or pseudogout

Management:
Rest, ice, NSAIDs.
Corticosteroid injections if persistent.

Question 16

Chronic Fatigue Syndrome (CFS)

Answer 16

Signs and Symptoms: Persistent fatigue, muscle pain, sleep disturbances, cognitive impairment.
Investigations: Diagnosis of exclusion (rule out other conditions).
Management:
Cognitive behavioral therapy (CBT), graded exercise therapy.
Symptomatic management (pain relief, sleep aids).

Question 17

Chronic Kidney Disease (CKD)

Answer 17

Signs and Symptoms: Fatigue, ankle swelling, nocturia, uraemia in advanced stages.
Investigations: eGFR, urine albumin:creatinine ratio, creatinine levels.
Management:
Blood pressure and diabetes control.
ACE inhibitors/ARBs to reduce progression.
Dialysis or transplantation in end-stage disease.

Question 18

Chronic Obstructive Pulmonary Disease (COPD)

Answer 18

Signs and Symptoms: Chronic cough, sputum production, shortness of breath.
Investigations: Spirometry, chest X-ray, blood gas analysis.
Management:
Smoking cessation, bronchodilators (SABA/LABA), corticosteroids.
Oxygen therapy if severe.

Question 19

Conjunctivitis

Answer 19

Signs and Symptoms: Red, itchy eyes, watery discharge, photophobia.
Investigations: Clinical diagnosis, swab if bacterial suspected.
Management:
Viral: supportive care, artificial tears.
Bacterial: antibiotic eye drops (e.g., chloramphenicol).
Allergic: antihistamines or mast cell stabilizers.

Question 20

Constipation

Answer 20

Signs and Symptoms: Infrequent bowel movements, straining, hard stools.
Investigations: Clinical diagnosis, stool tests if secondary cause suspected.
Management:
Increase fiber intake, hydration, and physical activity.
Laxatives (bulk-forming, osmotic) for relief.

Question 21

Contact Dermatitis

Answer 21

Signs and Symptoms: Red, itchy, inflamed skin in response to allergens/irritants.
Investigations: Patch testing.
Management:
Avoidance of trigger, topical steroids.
Emollients to maintain skin barrier.

Question 22

Crystal Arthropathy (e.g., Gout)

Answer 22

Signs and Symptoms: Acute joint pain, swelling, redness, usually in the big toe.
Investigations: Joint aspiration for crystals, serum urate levels.
Management:
NSAIDs, colchicine during acute flare-ups.
Long-term management with allopurinol.

Question 23

Cutaneous Fungal Infection

Answer 23

Signs and Symptoms: Red, scaly, itchy rash, often ring-like.
Investigations: Skin scraping, KOH examination, fungal culture.
Management:
Topical antifungals (clotrimazole, terbinafine).
Oral antifungals if widespread.

Question 24

Cutaneous Warts

Answer 24

Signs and Symptoms: Small, hard, raised growths on skin.
Investigations: Clinical diagnosis.
Management:
Topical treatments (salicylic acid, cryotherapy).

Question 25

Hiatus Hernia

Answer 25

Signs and Symptoms: Heartburn, regurgitation, chest pain, difficulty swallowing, belching. Investigations: Barium swallow, endoscopy, pH monitoring. Management: Lifestyle modifications (elevating head of bed, avoiding large meals). Antacids, proton pump inhibitors (PPIs), H2 blockers. Surgery (fundoplication) if severe.

Question 26

hypothyroidism and Hyperthyroidism

Answer 26

Signs and Symptoms: Hypothyroidism: Fatigue, weight gain, cold intolerance, constipation, dry skin, bradycardia. Hyperthyroidism: Weight loss, heat intolerance, palpitations, tremors, anxiety, tachycardia. Investigations: TSH, Free T4, Free T3, thyroid antibodies. Management: Hypothyroidism: Levothyroxine. Hyperthyroidism: Antithyroid drugs (e.g., carbimazole), beta-blockers for symptom control, radioactive iodine, or surgery.

Question 27

Infectious Mononucleosis- Glandular fever

Answer 27

Signs and Symptoms: Sore throat, fever, lymphadenopathy, splenomegaly, fatigue. Investigations: Monospot test, EBV serology (VCA-IgM, VCA-IgG). Amoxicillin or cephalosporins cause rash. Management: Symptomatic treatment (analgesics, hydration). Avoid contact sports due to risk of splenic rupture.

Question 28

Influenza

Answer 28

Signs and Symptoms: Fever, chills, cough, sore throat, muscle aches, fatigue. Investigations: Rapid antigen test, PCR, nasopharyngeal swab. Management: Antivirals (oseltamivir, zanamivir) within 48 hours if severe or high risk. Symptomatic management (fluids, rest, analgesics).

Question 29

Irritable Bowel Syndrome (IBS)

Answer 29

Signs and Symptoms: Abdominal pain, bloating, diarrhea, constipation, changes in stool appearance. Investigations: Diagnosis of exclusion, stool studies, blood tests, colonoscopy if red flags are present. Management: Dietary changes (low FODMAP diet), fiber supplements. Antispasmodics (hyoscine), laxatives for constipation, anti-diarrheal medications. Psychological interventions (CBT).

Question 30

Lower Limb Soft Tissue Injury

Answer 30

Signs and Symptoms: Pain, swelling, bruising, limited range of motion, possible deformity. Investigations: Clinical examination, X-rays if fracture suspected. Management: R.I.C.E. (Rest, Ice, Compression, Elevation). NSAIDs for pain relief, physiotherapy for rehabilitation.

Question 31

Mumps

Answer 31

Signs and Symptoms: Swollen, painful parotid glands, fever, headache, malaise, anorexia. Investigations: Clinical diagnosis, PCR or serology for mumps virus. Management: Symptomatic treatment (analgesics, hydration). Isolation to prevent spread.

Question 32

Obesity

Answer 32

Signs and Symptoms: Excess body fat, increased BMI (>30), potential comorbidities like diabetes, hypertension. Investigations: BMI calculation, waist circumference, blood tests (lipid profile, glucose). Management: Dietary changes (calorie reduction), increased physical activity. Pharmacotherapy (orlistat, GLP-1 agonists), bariatric surgery in severe cases.

Question 33

Osteoarthritis

Answer 33

Signs and Symptoms: Joint pain, stiffness, reduced range of motion, swelling, crepitus. Investigations: X-ray (joint space narrowing, osteophytes). Management: NSAIDs, paracetamol for pain relief. Physiotherapy, weight loss, joint replacement surgery if severe.

Question 34

Osteoporosis

Answer 34

Signs and Symptoms: Bone fractures (common in the hip, spine, wrist), back pain, loss of height, stooped posture. Investigations: DEXA scan (bone mineral density), blood tests for calcium, vitamin D, thyroid function. Management: Bisphosphonates (e.g., alendronate), calcium, and vitamin D supplements. Weight-bearing exercises.

Question 35

Peripheral Vascular Disease (PVD)

Answer 35

Signs and Symptoms: Intermittent claudication (pain in legs with walking), ulcers, cold and pale extremities. Investigations: Ankle-brachial index (ABI), Doppler ultrasound, angiography. Management: Lifestyle changes (smoking cessation, exercise). Antiplatelet agents (aspirin, clopidogrel), statins. Revascularization if severe.

Question 36

Polymyalgia Rheumatica

Answer 36

Signs and Symptoms: Pain and stiffness in shoulders, hips, and neck, fatigue, weight loss. Investigations: Elevated ESR, CRP, clinical diagnosis. Management: Low-dose corticosteroids (prednisolone). Gradual tapering of steroids.

Question 37

Prostate Cancer

Answer 37

Signs and Symptoms: Urinary symptoms (weak stream, hesitancy), blood in urine, back pain, weight loss. Investigations: PSA levels, digital rectal exam (DRE), biopsy, MRI. Management: Active surveillance, surgery (radical prostatectomy), radiotherapy. Hormonal therapy (androgen deprivation therapy), chemotherapy in advanced cases.

Question 38

Psoriasis

Answer 38

Signs and Symptoms: Red, scaly patches, often on elbows, knees, scalp, and lower back. Investigations: Clinical diagnosis, skin biopsy in uncertain cases. Management: Topical corticosteroids, vitamin D analogs (calcipotriol). Phototherapy, systemic biologic drugs (e.g., TNF inhibitors).

Question 39

Reactive Arthritis

Answer 39

Signs and Symptoms: Joint pain (often in lower limbs), conjunctivitis, urethritis, skin rashes. Investigations: HLA-B27 test, joint fluid analysis, ESR, CRP. Management: NSAIDs for pain control. Antibiotics for infections (e.g., chlamydia), corticosteroids or DMARDs for persistent symptoms.

Question 40

Rhinosinusitis

Answer 40

Signs and Symptoms: Nasal congestion, facial pain/pressure, purulent nasal discharge, cough, headache. Investigations: Clinical diagnosis, CT scan if chronic or complicated. Management: Nasal decongestants, saline irrigation. Antibiotics if bacterial infection suspected, corticosteroids for chronic cases.

Question 41

Tonsillitis

Answer 41

Signs and Symptoms: Sore throat, fever, difficulty swallowing, enlarged tonsils, white patches on tonsils. Investigations: Throat swab for Streptococcus (Rapid antigen test or culture). Management: CENTOR criteria Symptomatic treatment (analgesics, fluids). Antibiotics (penicillin) for bacterial infections.

Question 42

Urinary Incontinence

Answer 42

Signs and Symptoms: Involuntary urine leakage, urgency, frequency, nocturia. Investigations: Urinalysis, bladder diary, post-void residual volume. Management: Lifestyle modifications (fluid management, pelvic floor exercises). Medications (antimuscarinics, beta-3 agonists). Surgery if severe (e.g., sling procedures).

Question 43

Urinary Tract Infection (UTI)

Answer 43

Signs and Symptoms: Dysuria, frequency, urgency, cloudy or foul-smelling urine, lower abdominal pain. Investigations: Urine dipstick, urine culture. Management: Antibiotics (e.g., trimethoprim, nitrofurantoin). Pain relief with NSAIDs or paracetamol.

Question 44

Urticaria (Hives)

Answer 44

Signs and Symptoms: Itchy, raised, red welts or hives on the skin, often with swelling. Investigations: Clinical diagnosis, allergen testing if suspected. Management: Antihistamines, corticosteroids for severe cases. Avoidance of triggers (e.g., certain foods, drugs, stress).

Question 45

Varicose Veins

Answer 45

Signs and Symptoms: Swollen, twisted veins visible just under the skin, aching, heaviness, cramps, swelling in legs, especially after standing for long periods. Investigations: Clinical examination, duplex ultrasound to assess blood flow. Management: Conservative: Compression stockings, elevation of legs, lifestyle changes (weight management, regular exercise). Medical: Sclerotherapy, laser therapy. Surgical: Vein stripping or endovenous laser treatment for severe cases.

Question 46

Vasovagal Syncope

Answer 46

Signs and Symptoms: Sudden fainting (syncope), dizziness, nausea, pallor, sweating, typically after standing up or stress. Investigations: Clinical diagnosis, orthostatic blood pressure measurements, ECG, tilt-table test. Management: Education (avoid triggers, hydrate, sit/lie down when feeling faint). Lifestyle changes (avoid prolonged standing, increase salt and fluid intake). In severe cases, beta-blockers, fludrocortisone, or pacemaker may be considered.

Question 47

Venous Ulcers

Answer 47

Signs and Symptoms: Painful, non-healing ulcers on the lower legs, typically near the ankle, with associated swelling, redness, and varicose veins. Investigations: Clinical examination, Doppler ultrasound to assess venous insufficiency. Management: Compression therapy (bandages, stockings) to improve venous return. Wound care (cleansing, debridement, topical treatments). Surgery (for severe cases) or venous interventions like sclerotherapy or vein stripping.

Question 48

Viral Gastroenteritis

Answer 48

Signs and Symptoms: Diarrhea, vomiting, abdominal cramps, nausea, fever, headache, muscle aches. Investigations: Clinical diagnosis; stool tests if infection type needs confirmation (e.g., rotavirus, norovirus, enteric adenovirus). Management: Fluid and electrolyte replacement (oral rehydration solutions). Symptomatic treatment (antiemetics, antidiarrheals). Avoidance of antibiotics unless bacterial infection is suspected.

Question 49

Benign eyelid disorders

Answer 49

Blepharitis: Inflammation of the eyelid, leading cause of dry eye disease. Symptoms: bilateral ocular irritation, foreign body sensation, burning, redness, crusting. Causes: atopic dermatitis, seborrheic dermatitis, acne rosacea, Demodex mites. Treatment: lid hygiene (warm compress, eyelid massage, cleaning), topical antibiotics (chloramphenicol), low-dose oral tetracyclines, omega-3 supplements. Hordeolum (stye): Staphylococcal infection of an eyelash follicle (external) or meibomian gland (internal). Presents as tender, red eyelash follicle swellings. Treatment: warm compress, eyelash removal, incision with a sterile needle, topical/oral antibiotics if recurrent or severe. Chalazion: Non-infectious granulomatous inflammation of a meibomian gland. Presents as painless red eyelid cysts. Often associated with blepharitis and acne rosacea. Treatment: warm compress, eyelid massage. Persistent cases require ophthalmology referral for incision and curettage. Entropion: Inward turning of the eyelid, leading to corneal irritation and potential ulceration. Causes: age-related changes, eyelid irritation, scarring, trachoma. Treatment: examine for corneal abrasions/ulcers, prescribe lubricants, advise eyelid taping, refer for surgical correction. Ectropion: Outward turning of the eyelid, often due to age-related changes or facial nerve palsy (Bell’s palsy). Presents with a sore, red, watery eye due to disrupted tear drainage. Treatment: lubricating eye drops, taping eyes shut at night, corrective surgery for severe cases. Urgent referral for exposure keratopathy. Trichiasis: Inward-growing eyelashes due to damaged follicles, causing corneal irritation and potential ulceration. Often due to chronic blepharitis. Treatment: epilation of eyelashes, electrolysis, or laser ablation for more permanent solutions. Examine for corneal damage