GP Flashcards

Question 1

Q

Whats ages do health workers work with?

Question 2

Q

Give 3 roles of the health visitor

Answer

A

) Ante-natal and post-natal support
) Support parents
) Advice on feeding
) Support special needs
) Advise on behavioural management techniques
) Advice on reducing risks and accidents
) Information on local services
) Safeguarding

Question 3

Q

What is the red book/PCHR?

Answer

A

Personal child health record

Question 4

Q

Give 3 purposes of a 6-8 week baby check

Answer

A

) Detect congenital heart disease
) Developmental dysplasia of hip
) Congenital cataract
) Undescended testes
) Hernias

Question 5

Q

Give 3 things children are vaccinated against at 8 weeks

Answer

A

) Diphtheria
) Tetanus
) Pertussis (DTP)
) Polio
) H. influenzae
) Hep B
) Pneumococcal
) Meningococcal group B
) Rotavirus gastroenteritis

Question 6

Q

Give 3 things children are vaccinated against at 12 weeks

Answer

A

) DTP
) Polio
) Hib
) Hep B
) Pneumococcal
) Men B

Question 7

Q

Give 3 things children are vaccinated against at 16 weeks

Answer

A

) DTP
) Polio
) Hib
) Hep B
) Pneumoccocal
) Men B

Question 8

Q

Give 3 things children are vaccinated against at 12 months

Answer

A

) Hib
) Men C
) Pneumococcal
) MMR
) Men B

Question 9

Q

What are girls aged 12-13 given a vaccination of?

Answer

A

Human papillomavirus (HPV)

Question 10

Q

What is the aim of vaccination?

Answer

A

To produce a rapid protective immune response upon re-exposure to that pathogen

Question 11

Q

Give the steps of the pathogenesis of vaccination with T cells (6)

Answer

A

1) Macrophages ingest attacker/fragments
2) Travel to lymph nodes
3) Use class II MHC molecules to present antigens
4) Helper T cell receptors recognise antigens
5) Helper T cell receptors bind and trigger helper T cells to proliferate
6) Eventually some of helper T cells become memory cells

Question 12

Q

Give the steps of the pathogenesis of vaccination with B cells (4)

Answer

A

1) B cell receptors recognise attacker/fragment of attacker from APC
2) B cell triggered
3) Proliferates and makes plasma cells to make lots of the same antibody
4) Some B cells become memory cells

Question 13

Q

Give the 3 types of vaccine

Answer

A

) Inactivated
) Attenuated
) Live vaccines

Question 14

Q

Give 3 differential diagnoses for a cough

Answer

A

) Asthma
) Acute respiratory infection
) GORD
) Seasonal allergic rhinitis
) Post infectious cough
) Pertussis
) Pneumonia
) Head cold
) TB
) Inhaled foreign body
) Bronchiolitis

Question 15

Q

Give 3 differential diagnoses for SOB

Answer

A

) Asthma
) Severe anaemia
) Pneumothorax
) Pulmonary oedema
) COPD
) Arrhythmia
) Lower respiratory tract infection
) Panic attacks
) Metabolic acidosis
) PE

Question 16

Q

Give 2 measurements a spirometry shows

Answer

A

) Amount of air you breathe out in 1 second

- ) Total amount of air in lungs

Question 17

Q

What is a peak flow test?

Answer

A

How fast you can blow air out of your lungs in one breath

Question 18

Q

Give 2 tests for breast cancer

Answer

A

) Mammogram
) US
) Core biopsy
) Fine needle aspiration

Question 19

Q

Give 3 presenting symptoms of breast cancer

Answer

A

) Breast lump
) Nipple change
) Nipple discharge
) Bloodstained discharge from nipple
) Skin contour changes
) Axillary lumps
) Breast pain/mastalgia
) Symptoms of metastatic disease

Question 20

Q

What are we looking for in a breast inspection?

Answer

A

) Variations in breast size and contour
) Inverted nipple? Uni/bilateral?
) Any oedema?
) Redness/retraction of skin
) Dimpling of skin (orange peel)

Question 21

Q

How do we palpate a breast in examination?

Answer

A

) Flat hand of 2,3,4th fingers
) Circle outwards from nipple
) Increase axillary tail and axilla
) Light, medium then deep pressure
) Assess mobility of lump (attached to skin/tissue?)
) Both breasts

Question 22

Q

When should we urgently refer to a breast clinic and see within 2 weeks?

Answer

A

) Suspicious breast lump
) Persistent/unexplained lump in axilla
) Unilateral nipple discharge, retraction, ulceration, distortion, eczema resistant to topical steroids, changes of concern
) Skin changes including nodules, ulceration, peau d’orange, dimpling
) Unilateral non cyclical breast pain persisting beyond one menstrual cycle
) Men >50 with subareolar lump

Question 23

Q

Give 3 systemic symptoms of breast cancer

Answer

A

) Weight loss
) Fever
) Lethargy
) Pain elsewhere
) Gland swelling

Question 24

Q

Give 2 medications we need to ask about in breast cancer investigations

Answer

A

) HRT

- ) Oral contraceptive pill

Question 25

Q

What does BRCA stand for?

Answer

A

Breast cancer gene

Question 26

Q

What does BRCA do when it functions normally?

Answer

A

Acts to repair cell damage to keep breast, ovarian and other cells growing normally - TUMOUR SUPPRESSORS

Question 27

Q

What are BRCAs considered, as they are associated with a high risk of developing breast cancer?

Answer

A

High penetrance

Question 28

Q

What other mutations (not BRCAs) are linked to a higher breast cancer risk?

Answer

A

SNPs, single nucleotide polymorphisms

Question 29

Q

Men with an abnormal what have a higher risk of breast cancer?

Question 30

Q

Give 2 risk reducing surgeries for breast cancer

Answer

A

) Mastectomy

- ) Oophorectomy

Question 31

Q

What does an oophorectomy lead to?

Answer

A

Early menopause

Question 32

Q

Give an advantage of having a genetic test for BRCA

Answer

A

) Positive - take steps to manage risk

- ) Less stress and anxiety from not knowing

Question 33

Q

Give a disadvantage of having a genetic test for BRCA

Answer

A

) Results sometimes inconclusive

- ) Positive result can cause permanent anxiety

Question 34

Q

Is BRCA autosomal dominant or recessive?

Question 35

Q

Give 3 ways we manage our risk of breast cancer

Answer

A

) Regularly examine breasts
) Screening
) Lifestyle changes
) Medication
) Risk-reducing surgery

Question 36

Q

What is the AMONA management for an acute MI?

Answer

A

Ambulance
Morphine
Oxygen
Nitrates
Aspirin

Question 37

Q

Give 3 differential diagnoses for chest pain

Answer

A

) Heartburn
) Indigestion
) Chest sprain/strain
) Anxiety/panic attack
) Chest infection/pneumonia
) Shingles

Question 38

Q

What are the 9 areas of the abdomen?

Answer

A

) L hypochondriac
) Epigastric
) R hypochondriac
) L lumbar
) Umbilical
) R lumbar
) L iliac fossa
) Suprapubic
) R iliac fossa

Question 39

Q

Give 4 things we look for in an abdominal examination

Answer

A

) Scars
) Ascites
) Masses
) Pulsation
) Cullen’s sign (bruising around umbilicus)
) Grey-Turner’s sign (bruising in flanks)
) Abdominal distension
) Striae
) Caput medusae
) Stomas

Question 40

Q

What are we assessing for on abdominal palpation?

Answer

A

) Tenderness
) Rebound tenderness (peritonitis)
) Guarding
) Masses

Question 41

Q

What are the steps of an abdominal examination? (9)

Answer

A

1) Observation
2) Light palpation
3) Deep palpation
4) Liver
5) Gallbladder (not usually palpable)
6) Spleen (not usually palpable)
7) Kidneys
8) Aorta
9) Bladder (empty not palpable)

Question 42

Q

What is Murphy’s sign?

Answer

A

) Place hand in R costal margin mid-clavicular line
) Patient takes deep breath
) Sudden stop in inspiration due to pain
) Positive if no discomfort in same location on left

Question 43

Q

What does liver tenderness suggest?

Answer

A

Hepatitis

Question 44

Q

What can a pulsatile enlarged liver be caused by?

Answer

A

Tricuspid regurgitation

Question 45

Q

What does an outward movement on aorta examination indicate?

Answer

A

Expansile, suggestive of AAA

Question 46

Q

What should we suspect if there is acute diarrhoea?

Answer

A

Gastoenteritis

Question 47

Q

Give 3 risk factors for diarrhoea

Answer

A

) Travel
) Insect bites
) Contact with dirty water
) Contact with D&V
) Diet change

Question 48

Q

What do we ask about diarrhoea?

Answer

A

) Consistency
) Mucous
) Blood
) Urgency

Question 49

Q

Give 3 infectious causes of diarrhoea

Answer

A

) Campylobacter
) E. coli
) Norovirus
) Rotavirus
) Malaria
) Giardiasis

Question 50

Q

Give 3 non-infectious causes of diarrhoea

Answer

A

) IBD
) IBS
) Anxiety
) Allergy/intolerance
) Chronic pancreatitis
) Diverticular disease
) Bowel cancer
) Surgery

Question 51

Q

Give 3 medications that can cause diarrhoea

Answer

A

) Laxatives
) Antacids
) Long term antibiotics
) Chemo drugs
) NSAIDs
) SSRIs

Question 52

Q

What 2 main tests do we do in a patient with chronic diarrhoea?

Answer

A

Blood work and stool tests

Question 53

Q

Give 3 things a patient should not have when having a PSA test

Answer

A

-) Active urine infection
-) Produced semen (ejaculated) in previous 48hrs
-) Exercised heavily in previous 48hrs
-) Prostate biopsy in last 6 weeks
-) DRE in previous week
CIs that can produce a high PSA

Question 54

Q

How does the definition of a normal PSA result change?

Answer

A

Increases as you get older

Question 55

Q

How do we do a prostate biopsy?

Answer

A

US guided, 12 or more small cores of prostate tissue examined

Question 56

Q

Give 3 treatment options for prostate cancer

Answer

A

) Watchful waiting (no DRE, more palliative)
) Active surveillance (DREs and prostate biopsies)
) Radical prostatectomy
) Hormone therapy (castration, androgen deprivation)
) Radical radiotherapy

Question 57

Q

Give 2 risks of a radical prostatectomy

Answer

A

) Urinary incontinence
) ED
) Incomplete resection of tumour

Question 58

Q

Give the 4 main treatment options for an enlarged prostate gland

Answer

A

) Lifestyle changes
) Medication
) Catheters
) Surgery

Question 59

Q

Give 3 lifestyle changes for an enlarged prostate gland

Answer

A

) Fewer fizzy drinks, alcohol, caffeine, artificial sweeteners
) Drink less in evening
) Remember to empty bladder
) More fruit and fibre
) Pads/sheath
) Bladder training
) Exercises

Question 60

Q

Give 3 medications for an enlarged prostate gland

Answer

A

) Alpha blockers
) Anticholinergics
) 5-alpha reductase inhibitors
) Diuretics
) Desmopressins

Question 61

Q

How do alpha blockers work, and give an example (enlarged prostate gland)

Answer

A

) Relax muscle in prostate gland and base of bladder

- ) Tamsulosin and alfuzosin

Question 62

Q

Give an example of a 5-alpha reductase inhibitor

Answer

A

Finasteride, dutasteride

Question 63

Q

When should we give diuretics and desmopressins in an enlarged prostate gland?

Answer

A

Diuretics speed up urine production - daytime

Desmopressins slow down urine production - nighttime

Question 64

Q

Give 3 surgical options for an enlarged prostate gland

Answer

A

) Transurethral resection of prostate
) Open prostatectomy
) Cystoplasty
) Botulinum toxin
) Implanted sacral nerve root stimulation
) Urinary diversion

Answer 62

A

On their side with their knees up to their abdomen

Answer 63

A

) Size
) Consistency (smooth, nodules, masses)
) Tenderness
) Fluctuations

Answer 64

A

) Size and shape
) Regularity
) Consistency
) Discomfort
) Fixed/separate to testicle
) Transilumination

Answer 65

A

Lots of false negatives and positives

Answer 66

A

) Lack of knowledge about need
) Don’t know how to register
) Uncertainty about faith’s position
) Religiously permissible?
) Issue of trust in allocation procedures
) Perceived lack of relevance for own community
) Language barriers

Answer 67

A

) Transplant
) Dialysis
) Palliative care

Answer 68

A

Black and South Asian

Answer 69

A

) Continuous removal of waste products and excess fluid
) Production of EPO
) Conversion of vitamin D into active compound
) Excretion of some drugs
) Control of BP

Answer 70

A

) NSAIDs
) Aminoglycosides
) IV radiocontrast agents

Answer 71

A

Build up of fatty despots in blood vessels supplying kidneys

Answer 72

A

) PCR (protein:creatinine ratio)

- ) ACR (albumin:creatinine radio)

Answer 73

A

) Preferred place of death (and carer willingness and availability)
) Making will/living will
) Power of attorney
) DNAR status
) Involving faith leaders
) Contact details for health care professionals out of ours
) Planning a funeral

Answer 74

A

Internal iliac artery

Answer 75

A

) Rejection
) SEs of steroids
) Skin cancers
) Solid tumours
) Lymphoma
) High risk pregnancy

Answer 76

A

Haemodialysis, peritoneal dialysis

Answer 77

A

) BP
) U&Es, FBCs, HbA1C, lipid, ACR, PCR, alkaline phosphate, Ca, PTH, vitamin D
) EPO (chronic anaemia with normal iron levels)
) DEXA

Answer 78

A

) RA
) Spondyloarthritis
) Crystal arthritis

Answer 79

A

Normochromic, normocytic anaemia and thrombocytosis

Answer 80

A

An auto-antibody directed against the Fc region of an Ig, form immune complexes and active the complement system

Answer 81

A

) Anti CCP
) ANA
) DsDNA
) ENA
) RF

Answer 82

A

Treat symptoms and slow down the progression of the disease

Answer 83

A

) Gold injections
) Hydroxychloroquine
) Leflunomide
) Methotrexate
) Sulfasalazine

Answer 84

A

) DMARDs
) Biological therapies (type of DMARD)
) Immunosuppression with corticosteroids
) NSAIDs before DMARDs

Answer 85

A

) Nausea
) Loss of appetite
) Sore mouth
) Diarrhoea
) Headaches
) Hair loss
) Pancytopenia
) Leucopenia
) Thrombocytopenia
) Megaloblastic anaemia

Answer 86

A

) Blood count
) Liver
) Kidneys
) Eyes
) Lungs

Answer 87

A

Measure of disease activity

) Number of swollen joints
) Number of tender joints
) ESR/CRP
) Patient gives global assessment of health 1-10

Answer 88

A

Folic acid tablets

Answer 89

A

) >3 joints affected
) Tenderness on palpation
) Synovitis of affected areas
) Positive squeeze test across MCPJs

Answer 90

A

) Current symptoms
) Evolution of problem
) Involvement of other systems
) Systemic symptoms
) FHx
) History of other autoimmune disease
) Impact on patient’s life
) Other joints than presenting joint

Answer 91

A

Site
Onset
Character (dull, stabbing)
Radiation
Associations
Time course
Exacerbating/relieving factors
Severity

Answer 92

A

) Stiffness - OA less stiff
) Pain with use - OA more pain, less pain with rest
) Number of joints
) Symmetry - OA asymmetric
) Acute
) Tenderness/redness - RA

Answer 93

A

) OA
) Gout (v. acute)
) Pseudogout
) Septic arthritis

Answer 94

A

) RA
) Viral infections
) Spondyloarthropathies

Answer 95

A

) Infliximab

- ) Rituximab

Answer 96

A

Shared care protocol

) Hospital appt with consultant every 6-12 months
) Blood tests every 3 months (hospital nurse/GP)
) Contact as necessary by phone with rheumatology nurses

Answer 97

A

) FBC
) U&E
) LFTs
) Possible BP and urine test
) Eyesight test with hydroxychloroquine

Answer 98

A

) Anxiety and emotional distress
) Undermines wellbeing
) Interferes with functional capacity
) Stops one from fulfilling family, social, vocational roles

Answer 99

A

) Tense
) Easily angered and hostile
) Hopeless, depression
) Difficulties with sleeping

Answer 100

A

) Bathing
) Dressing
) Toileting
) Tranferring
) Continence
) Feeding

Answer 101

A

) Trying to beat it
) Boom and bust
) Complete avoidance

Answer 102

A

) Oral analgesics
) Topical NSAIDs
) NSAIDs and highly selective COX2 inhibitors
) Intra-articular injection of corticosteroids

Answer 103

A

) Exercise and manual therapy
) Weight loss
) Transcutaneous electrical nerve stimulation
) Aids/devices

Answer 104

A

) Non opioid +/- adjuvant
) Weak opioid +/- non-opioid, +/- adjuvant
) Strong opioid +/- non-opioid, +/- adjuvant

Answer 105

A

) Antidepressants
) Anti-seizure
) Muscle relaxants
) Sedatives
) Anti-anxiety
) Botulinum toxin

Answer 106

A

) Aspirin
) Paracetamol
) NSAID
) Nafopam

Answer 107

A

) Codeine
) Dihydrocodeine
) Tramadol

Answer 108

A

) Morphine
) Fentanyl
) Oxycodone
) Dimorphine

Answer 109

A

) Gait
) Anterior inspection
) Posterior inspection

Answer 110

A

) Palpitation with leg straight and relaxed
) Joint effusion assessment
) Palpation with knee bent to 90 degrees

Answer 111

A

Active and passive

Answer 112

A

) Ligament tests

- ) Meniscal damage

Answer 113

A

) Acceptance
) Support team
) Pacing
) Prioritising
) Setting goals/action plans
) Be patient
) Relaxation
) Stretching and exercise
) Setback plan

Answer 114

A

) Surgery
) Radiotherapy
) Chemotherapy
) Hormone therapy
) Biological therapy (targeted therapy)

Answer 115

A

) Tamoxifen
) Aromatase inhibitors (after menopause)
) Ovarian ablation or suppression

Answer 116

A

Trastuzumab for HER-2 positive cancers

Answer 117

A

Human epidermal growth factor receptor 2

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GP Flashcards

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