GP 4th Year Flashcards
What side effect needs to be monitored with prolonged use of oral anti-fungals such as fluconizole and terbinafine?
LFTs
Name the medication used for resistant obesity and weight loss. Name the side effect caused by this drug.
Orlistat (oral)
Pale stools
What medications can be used to treat and prevent osteoporosis?
Bisphosphonates (ex. Alendronic acid)
Vitamin D
Side effect to be aware of in bisphosphonates?
Ex. Alendronic acid
Osteonecrosis of the Jaw
Dysphagia/Oesophagitis/GORD
Side effect to be aware of in bisphosphonates?
Ex. Alendronic acid
Osteonecrosis of the Jaw
Dysphagia/Oesophagitis/GORD
Missed pill rules:
If pills are missed in week 1: _____
If pills are missed in week 2: ____
If pills are missed in week 3: ____
Week 1 : Use emergency contraception if she had UPSI in pill free interval for 1 week
Week 2: no need for emergency contraception
Week 3: Take the last pill that was missed, finish the current pack and start the next pack immediately after.
Ellaone works by inhibiting ovulation. It can be taken within ____ days of UPSI.
It is contraindicated in ____ and ____. Breast feeding must be avoided for one week after taking the medication.
5 days
Liver disease and asthma
It can also cause painful periods, mood swings and back pain.
If the patient vomits within 3 hours, she will need to see the doctor again as the pill will not have been absorbed.
Which scoring system can be used to measure back pain severity?
Keele Start Back

Ipratropium and Tiotropium Bromide are short and long acting _____, used in asthma and COPD.
Anti-Muscurinic
What are the causes of vomiting?

_____ crystals with _____ birefringence confirm gout and differentiate it from pseudogout, and the fluid should also be sent for gram stain and culture to rule out septic arthritis.
Needle-shaped monosodium urate
Negative
*Remember P for Postive birefringence and Pseudogout*

Gout is managed in terms of the acute attack, and then the ongoing management.
____, ____, ____, and ____ may all be used acutely, according to the patient’s co-morbidities. The NSAID indomethacin is traditionally used first-line. For patients with a high risk of gastro-intestinal side effects, past medical history of chronic kidney disease or heart failure, _____ may be used.
NSAIDs
colchicine
steroids
paracetamol
colchicine

In the management of Gout, Colchicine can give which side effect?
Diarrhoea (remember 60 yr old man w/ charlotte)
If intolerable to patients, intra articular administration of steroids may be considered.
Mnemonic for conservative management of MSK injuries?
PRICED
Protection
Rest
Ice
Compression
Elevation
Drugs (Ibuprofen etc)
Adhesive Capsulitis is associated with which other medical conditions?
Diabetes
Thyroid disease
*both risk factors for developing adhesive capsulitis*
____ test can be used to test for lateral epicondylitis (i.e Tennis Elbow)
Mill’s Test

Passive flexion of the thumb right across the palm is painful in de quervain’s tenosynovitis. This is called ____ test.
Finkelstein’s
In a patient with a low B12 and a high MCV which investigations need to be done next?
Anti-Intrinsic Factor antibodies (beware low sensitivity 50-60%)
or
Anti-Gastric parietal cell antibodies (low specificity)

Which cancers are predominantly asscoiated with a thrombocytosis?
Lung
Oesophageal and Gastric
Endometrial
Other causes of thrombocytosis :
- Haematological/Clonal thrombocytosis e.g. Primary/Essential Thrombocytosis
- Reactive/secondary thrombocytosis (infection/inflammation/trauma/non-haem malignancy)
What dermatological complication is associated with Coeliac disease?
Dematitis Herpetiformis (itchy blistery rash on legs)

Complications of coeliac disease:
Dermatitis Herpetiformis ( itchy blistering rash on legs)
Osteoporosis
GI Lymphoma
______ can be measured alongside copper to aid the diagnosis of Wilson’s disease.
Caeruloplasmin
Serum copper and caeruloplasmin levels are usually low in patients with Wilson’s disease, however caeruloplasmin may also be normal or elevated in these patients due to to the acute phase response.
As such serum caeruloplasmin alone has a low positive predictive value in patients undergoing evaluation for liver disease. Acute hepatitis in Wilson’s disease can increase caeruloplasmin into the normal range due to the acute phase response. An equivocal test should be followed by analysis of 24hr urine copper. The majority of Wilson’s disease patients are diagnosed between the ages of 5 and 35 years, although it has been diagnosed in younger patients and in those their 70s.
_____ genotype, USS and refer hepatologist (fibrosis scoring (FIB4)/fibroscan/liver biopsy) aids in the diagnosis of Haemochromatosis.
HFE
The gene HFE, which contains two missense mutations (C282Y and H63D) was recently identified in patients suffering from haemochromatosis.
- C282Y homozygous (80%)
- H63D (compound heterozygote C282Y/H63D 5%)
Haemochromatosis is an _____ condition.
Autosomal recessive




