GP Flashcards
If someone presents with heart failure, who has a PMHx of MI, what referral need to do?
Urgent Transthoractic Echo (TTE)
If someone has never had an MI, but present with BNP at 4000, what do you do?
Urgent TTE
How long can you wait before needing a TTE if your BNP is <4000?
= 6 weeks
What two things might you see on a HF ECG?
Hypertrophy
Ischaemia
What would you see on a CXR of HF?
Alveolar oedema B lines Cardiomegaly Diversion of upper lobe Effusion
What is first line treatment for heart failure?
ACEi and Beta blocker
What would you consider if 1st line treatment didn’t work for HF?
ARB (losartan, candesartan)
What medication might you consider in Afro-Caribbean people with HF?
Hydralazine with Nitrate
What is 3rd line for HF?
Digoxin
What are the 3 symptoms of typical angina?
- Constricting pain in chest, may radiate down arm and to jaw
- Brought on by exercise
- Relieved by GTN spray in 5 mins
What are angina patients given for symptoms control?
GTN
Beta blockers
CCB
What are angina patients given as preventative medicine?
Aspirin
Statins
What CANNOT be prescribed with Verapamil?
Beta blockers
Heart block
What type of drug is Ivabradine?
Anti-anginal
How does Ivabradine work?
Slows heart rate, reduces cardiac pacemaker affect
Side effects of Ivabradine?
Bradycardia
Headache
Visual problems
Long term Mx of COPD?
SABA +/- short acting anti-muscarinic
LABA +/- long acting anti-muscarinic
Long term oxygen therapy
What is the mechanism of Metformin?
Increases insulin sensitivity, hepatic gluconeogenesis and GI absorption of carbohydrates
What is the criteria for Sulphonylureas to actually work?
Must be some working beta cells (as the bind to them to increase insulin production)
What might you use in T2DM if metformin/gliclazide isn’t working?
SGLT2 - sodium glucose cotransporter 2
block renal absorption of glucose
e.g. canagliflozin
What are some side effects of SGLT2?
Thrush
UTI
Euglycaemic ketoacidosis
Weight loss
Give examples of dipeptidyl-peptidase 4 (DPP4) used in T2DM
Sitagliptin
Vildagliptin
Name 2 types of T2DM medications that do not cause hypoglycaemia
- Metformin
2. DDP4 - sitagliptin
How many medications do you need to use before insulin is considered in T2DM?
3 (triple therapy)
A patient of BMI 30 is non well controlled on triple therapy. What do you want to try next?
Glucagon-like-peptide 1 (GLP1)
Give an example of a GLP1
Exenatide
Name 3 side effects of insulin
Weight gain
Hypoglycaemia
Lipodystrophy
Name 5 risk factors for chronic kidney disease
Hypertension Diabetes Polycystic kidney disease Renal artery stenosis Glomerulonephritis
What foods must someone with CKD avoid?
Phosphate and potassium
What reverses the action of warfarin?
Vitamin K
What medication is mainly used in Alzheimer’s?
Donepezil
If a dementia patient has visual hallucinations, relatively preserved memory and fluctuations in cognition, what type of dementia might you suspect?
Lewy Body
Which type of dementia can be preventable?
Vascular
What condition is front-temporal dementia linked to?
Motor neurone disease
