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Phase 3A > GP > Flashcards

GP Flashcards

1
Q

How would you work out BMI?

A

Weight (kg) / height (m)2

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2
Q

What is considered a healthy BMI?

A

18.5 - 24.9

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3
Q

What investgiations should be done on an idividual that presents to the GP practice with hypertension?

A
  • ABPM 24 hours
  • Ophthalmology
  • ## CV risk assessment
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4
Q

What risk score would you use to stratify the risk of an individual with AF having a stroke?

List all of the criteria

A

CHADS(2)VASc

CHD
Hypertension 
Age (>75) 
Diabetes
Stroke / TIA / VTE
Vascular disease
Age 65-74
Sex

> 1 consider anticoagulants

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5
Q

What risk score would you use to stratify the risk of an individual that has had a TIA having a stroke?

What score is classed as a high risk?

A

ABCD2

Age
BP
Clinical symptoms
Diabetes
Duration of symptoms

Out of 7
> 6 = high risk of having a stroke within the next 2 - 7 days

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6
Q

What are the differences when biopsying a patients rectum with UC and Chrons?

A

UC = goblet cell depeletion, crypt abscess, superficial inflammation, psuedopolyps

Chrons = granuloma, transmural involvement, skip lesions, cobblestoning appearance

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7
Q

What is the difference in treatment for chrons and UC?

A

UC = 5 ASA first (sulfasalazine). Surgery needs to take out the whole of the colon otherwise symptoms will return.

Chrons = steroids first. STOP SMOKING, may add on 5 ASA / methotrexate if its bad. Surgery is to take out the skip lesions.

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8
Q

What is the QRIsk 2 score and what is it used for?

A

To work out your risk of a heart attack or stroke within 10 years

Smoking
Diabetes
CKD
AF
Rheumatoid arthritis 
Angina / heart attack
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9
Q

What should your BP be to diagnose hypertension?

A

140-160/90-99

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10
Q

List 2 SE of ace inhibitors

A

Cause vasodilation and therefore reduce the peripheral vascular resistance (block AC enzyme, therefore prevent production of aldosterone that therefore reduces salt and water retention) and prevent brakdykinin breakdown - vasodilator.

  • Dry cough - bradykinin
  • postural hyptertension due to water depletion
  • do NOT prescribe NSAID, thiazide like diuretic and ACEi - can result in renal failure.
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11
Q

Give 6 signs of heart failure

A
  • Peripheral oedema
  • S3 (third heart sound)
  • Pleual effusion
  • HEPATOMEGALY (back flow of blood)
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12
Q

list 6 symptoms of heart failure

A
  • Paroxysmal nocturnal dyspnoea
  • Fatigue
  • Breahtlessness
  • Pink frothy sputum with cough
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13
Q

What staging system is used to classify heart disease?

A

New york heart association

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14
Q

What are the 5 signs seen on an Xray of someone with heart failure?

A 
Alevolar oedema (bat wing opacities) 
BKerly B lines
Cardiomegally
Dilated upper vessels
Effusion (pleural)
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15
Q

What tests would you do for someone with suspected heart failure?

A

NT-proBNP (lowered in obesity and those already on medications)

CXR

fbc

ecg - CAUSATIVE PROBLEM

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16
Q

What are the rules with heart failure and the DVLA?

A

Private car users - dont need to know

LGV drivers are disqualified

17
Q

What drugs should you give in heart failure?

A
  • ACEi
  • Diuretic
  • Beta blockers - may be used first line instead of ACEi in the elderly due to postural hypotension that they can cause.

DO NOT TAKE CALCIUM CHANNEL BLOCKERS (accept amlodipine)

18
Q

Give 4 lifestyle factors that you may need to make if you have heart failure?

A
  • Reduce salt intake
  • Increase exercise
  • Reduce alcohol
  • Stop smoking
  • Avoid stress
19
Q

Name one tertiary prevention for people with heart failure

A
  • Cardiac rehab groups
20
Q

List 3 reasons for reduced uptake of immunisations

A
  • No access to vaccinations in developing countries
  • Lack of trust in vaccine (MMR concerns)
  • Herd immunity thoughts
  • Time constraints
21
Q

List 3 reasons for uptake of immunisations

A
  • Know people that have had the vaccine - safe
  • Parents want to prevent child becoming ill
  • Trust in healthcare professional
22
Q

How do you report notifiabe diseases to PHE?

A
  • Verbally within 24 hours - urgent

- Written within 3 days

23
Q

List 3 mental examinations useful for screening dementia in GP

A
  • MMSE
  • GPCPOG
  • 6 CIT
24
Q

What propositions does the mental capacity act include?

A

Adults are assumed to have capacity unless proven otherwise

Individuals must be given all available support before it is concluded that they cannot make decisions for themselves

People must retain the right to make what may be seen as eccentric and unwise decisions

Anything done for a person without capacity must be in their best interests and should restrict their rights and basic freedoms as little as possible

25
Q

What are the three things that determine whether a person is deprived of their liberty?

A
  • under continuous supervision and control
  • not free to leave
  • person lacks capacity to consent to this
26
Q

What can you use to treat gonorrohoea / chlamydia?

A

Ceftriaxone and azithromycin

can be used to treat both and treats resistant strains too

27
Q

What are the fraser competencies?

A

that the girl (although under the age of 16 years of age) will understand his advice;
that he cannot persuade her to inform her parents or to allow him to inform the parents that she is seeking contraceptive advice;
that she is very likely to continue having sexual intercourse with or without contraceptive treatment;
that unless she receives contraceptive advice or treatment her physical or mental health or both are likely to suffer;
that her best interests require him to give her contraceptive advice, treatment or both without the parental consent.”

28
Q

What is the treatment for TB?

A

RIPE
6 months RI
2 months PE

29
Q

What are the symptoms of tb?

A

Pneumonia
BLOODY SPUTUM
Fever, malaise, weight loss
Pleural effusion

30
Q

How do you test for TB (microbiology)?

A
  • Ziehl Nelson

- Lowstein Jensen

31
Q

Name 3 at risk groups of TB

A
  • iMMUNOCOMPROMISED
  • homeless
  • Children
  • Those living in damp, confined spaces
32
Q

What is the vaccine for TB?

A

BCG

Phase 3A (17 decks)

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