GP Flashcards
Acne Vulgaris
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.
Acute Bronchitis
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.
Acute Stress Reaction
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.
Allergic Disorder
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.
Anaemia
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.
Anal Fissure
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.
Anaphylaxis
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.
Arrhythmias
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.
Asthma
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.
Atopic Dermatitis and Eczema
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).
Atrophic Vaginitis
Signs and Symptoms: Vaginal dryness, itching, painful intercourse.
Investigations: Clinical diagnosis, pelvic exam.
Management:
Vaginal estrogen therapy.
Lubricants for dryness.
Benign Eyelid Disorders
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.
Benign Paroxysmal Positional Vertigo (BPPV)
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.
Benign Prostatic Hyperplasia (BPH)
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.
Bursitis
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.
Chronic Fatigue Syndrome (CFS)
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).
Chronic Kidney Disease (CKD)
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.
Chronic Obstructive Pulmonary Disease (COPD)
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.
Conjunctivitis
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.
Constipation
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.
Contact Dermatitis
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.
Crystal Arthropathy (e.g., Gout)
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.
Cutaneous Fungal Infection
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.
Cutaneous Warts
Signs and Symptoms: Small, hard, raised growths on skin.
Investigations: Clinical diagnosis.
Management:
Topical treatments (salicylic acid, cryotherapy).
Hiatus Hernia
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.
hypothyroidism and Hyperthyroidism
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.
Infectious Mononucleosis- Glandular fever
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.
Influenza
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).
Irritable Bowel Syndrome (IBS)
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).
Lower Limb Soft Tissue Injury
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.
Mumps
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.
Obesity
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.
Osteoarthritis
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.
Osteoporosis
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.
Peripheral Vascular Disease (PVD)
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.
Polymyalgia Rheumatica
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.
Prostate Cancer
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.
Psoriasis
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).
Reactive Arthritis
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.
Rhinosinusitis
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.
Tonsillitis
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.
Urinary Incontinence
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).
Urinary Tract Infection (UTI)
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.
Urticaria (Hives)
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).
Varicose Veins
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.
Vasovagal Syncope
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.
Venous Ulcers
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.
Viral Gastroenteritis
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.
Benign eyelid disorders
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
