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Covo's KFP q's > GP > Flashcards

GP Flashcards

1
Q

What are some DDX for CAD?

A

Syphilis
Hyperthyroidism
Anaemia
Septic emboli
Collagen vascular disease (Kawasaki disease, polyarteritis nodosa, SLE, Ehlers-Danlos syndrome)
Other arrythmias (A Flutter, other atrial tachy-arrhythmias)

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2
Q

General categories of medications to manage CAD?

A

Rate control (beta blockers, CCBs, digoxin), Rhythm control, Anticoagulation (Warfarin, NOAC)

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3
Q

Which medications for CAD rate control do you choose if it is needed urgently IV?

A

Metoprolol 5mg (1mg/min) IV at 5 minute intervals up to max 20mg
Esmolol 500microg/kg over 1 min
Verapamil 1mg/min up to 15mg

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4
Q

What are some differentials for a sore throat?

A 
Necrotising fasciitis
Retropharyngeal abscess
Lemierres syndrome
Quinsy
Otitis media
Glomerulonephritis
Rheumatic fever
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5
Q

What is first line management for Croup?

A 
Inhaled corticosteroids (Budesonide, dex or pred)
\+/- adrenalin 0.1% (1:1000, 1mg/kg) 4mL nebs Q30 mins
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6
Q

What is the six step asthma management plan?

A

Assess severity of asthma
Achieve best lung function
Avoid trigger factors
Maintain best lung function with optimal medication
Develop and individua`lised written action plan
Educate and review regularly

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7
Q

How do you make a clinical diagnosis of (acute) Sinusitis?

A

With 2+ of:

  • Congestion
  • Nasal discharge
  • Facial pain
  • Hypoxmia/anosmia
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8
Q

How do you make a clinical diagnosis of bacterial sinusitis?

A

Symptoms of rhinosinusitis lasting >1 week + any of:

  • High fever lasting >3 days
  • Purulent nasal discharge
  • Sinus tenderness or maxillary toothace (esp. unilateral)
  • Severe symptoms or worsening symptoms post-initial improvement
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9
Q

What are some complications of sinusitis?

A 
Orbital cellulitis
Osteomyelitis
Abscess formation
Venous sinus thrombosis
Bacterial meningitis
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10
Q

What is first line for chronic sinusitis?

A

Prednisolone 25mg PO for 5-10/7

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11
Q

What is the BRAT diet?

A 
Diet used for gastro if diarrhoea continues or worsesn over about 3 days:
B = Bananas
R = Rice
A = Apples
T = Toast
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12
Q

What are the clinical features of Hirschprung disorder?

A 
Congenital
Constipation from infancy
Abdominal distension from infancy
Possible anorexia and vomiting
M:F ratio = 8:!
Narrow or normal rectum on exam
Dx confirmed by: full thickness biopsy showing absence of ganglion cells
Absent rectoanal reflex on anal manometry
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13
Q

What are the causes of acquired megacolon?

A 
Chronic laxative abuse
Mild Hirschprung disorder
Chagas disease
Hypothyroidism/cretinism
Systemic sclerosis
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14
Q

How do you manage angiodysplasia?

A

Blood transfusion - if loss significant

Cautery/argon plasma coag therapy through endoscopy

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15
Q

Management of gastroenteritis?

A

Fluid therapy
Electrolyte replacement

Empirical antibiotics:

  • Cipro 500mg (child: 12.5mg/kg up to 500mg) orally once daily for 3/7 OR
  • Norflox 400mg (child: 10mg/kg up to 400mg) orally adily for 3/7

Giardia: metronidazole 2g for 3/7

Entamoeba histolytica: Paromomycin 500mg (child: 10mg/kg up to 500mg), orally 8 hrly for 7 days

Clostridium difficile: Metronodazole 400mg for 10/7

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16
Q

When is empirical antibiotic therapy indicated for gastroenteritis?

A

When bacterial infection suspected in patients with features suggesting severe disease:
high fever, tachycardia, leukocytosis, abdominal tenderness or severe abdo pain, high-volume diarrhoea with hypovolemia, blood in the stool

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17
Q

Why is antibiotic therapy not recommended in children with bloody diarrhoea without fever?

A

If caused by EHEC can lead to haemolytic uremic syndrome

18
Q

What are some red flags for GORD?

A 
Anaemia
Dysphagia
Haematemesis and/or malaena
Vomiting
Weight loss
19
Q

Management for GORD?

A

Non pharmacological:

  • eating smaller meals
  • drinking f luids mostly between meals rather than with meals
  • avoiding lying down after eating
  • avoiding eating or drinking for 2-3 hrs before bedtime
  • avoid vigorous exercise before bedtime
  • elevate head of bed
  • stop smoking

Pharmacological:

  1. Antacid
  2. Alginate preparation 10-20mL PO PRN
  3. Mg hydroxide + Al hydroxide prep 10-20mL PO PRN
  4. H2 antagonist (ranitidine 150mg or famotidine 20mg PO BD)
  5. PPI (Esomeprazole/Omeprazole 20mg OR pantoprazole 40mg)
  6. Lap fundoplication
20
Q

How often should a patient to get fasting lipids tested?

A

<45 or <35 for ATSI with fasting lipids tested every 5 years

21
Q

What are the recommended treatment goals of dyslipidemia? (i.e. levels of lipids)

A

Total cholesterol <4.0 mmol/L
LDLC <2.5mmol/L
HDLC > 1.0 mmol/L
TG <1.5 mmol/L

22
Q

What the pharmacological management options for dyslipidemia?

A

Statin - e.g atorvastatin 10-80mg

Ezetimibe
Bile acid binding resins
Nicotinic acid
Fibrates

23
Q

What side effects are associated with nicotinic acid?

A

Flushing, gastric irritation, gout, impaired glucose tolerance

24
Q

What interactions occur associated with fibrates?

A

Fibrates + Statins = increased risk of myositis

25
Q

What are the presenting clinical features of patient with Vitamin B12 deficiency?

A

Anaemic symptoms: weakness, fatigue, palpitations, SOB, pallor

GIT symptoms: diarrhoea, consipation, loss ofbladder or bowel control

Neurological symptoms: Depression, Irritability, Peripheral neuropathy, Mania, Psychosis, Memory loss, Ataxia

Other: Tongue inflammation, Decreased taste, Poor growth and development, Easy bruising, bleeding, Bleeding gums

26
Q

Other than other types of anaemia - what are some DDx of B12 deficiency?

A 
Thiamine deficiency
Alcohol intoxication
Schizophrenia
Depression
Dementia
DIabetes
Leukemia
27
Q

What is the acute management for Vitamin B12 deficiency?

A

Hydroxocobalmin 1mg IM, on alternate days for 2 weeks

If severe anaemia/neurological symptoms: give supplementation ASAP

28
Q

What is the maintenance therapy for Vitamin B12 deficiency?

A

Lifelong therapy

  • Hydroxocobalamin 1mg IM, once every 2-3 months OR
  • Cyanocobalamin 50-200microg orally (daily between meals)
  • +/- K supplementation
29
Q

What is Wernicke’s encephalitis classical triad?

A

Opthalmoplegia (mostly bilateral LR with lateral nystagmus)
Ataxia
Confusion

30
Q

What is the management for Thiamine deficiency?

A

Thiamine 100mg PO daily (start with higher dose)

  • Administer thiamine before glucose for hypoglycemia as glucose can further deplete thiamine stores and precipitate Wernicke’s encephalopathy

+ promote increase in dietary thiamine

31
Q

What are red flags for iron deficiency anaemia?

A

in >65. it is colorectal cancer until proven otherwsie - do a DRE and colonoscopy

32
Q

How do you diagnose Haemophilia? (lab)

A

Normal BT, PT, TT

Prolonged PTT

33
Q

How do you diagnose ITP?

A

Diagnosis of exclusion:

Low platelet count
Bone marrow biopsy
Bone marrow examination
No blood abnormalities other than platelet count or no physical signs other than bleeding
Exclude secondary causes: leukemia, vWD, antiphospholipid syndrome

34
Q

How do you manage ITP?

A

MIld - careful observation
Mod-severe - Corticosteroids, IV Ig, Anti-D Ig, immunosuppressive drugs
Splenectomy - if unresponsive to steroid treatment

35
Q

What is treatment for TTP?

A

Supportive + Plasmaphoresis + Transfusion contraindicate: fuels coagulopathy

36
Q

What do these features indicate: malaise + pallor + bone pain?

A

ALL

37
Q

What do these features indicate: malaise + pallor + oral problems?

A

AML

38
Q

What do these features indicate: fatigue + fever + abdo fullness/splenomegaly?

A

CML

39
Q

What do these features indicate: fatigue + weight loss + fever + lymphadenopathy?

A

CLL

40
Q

How do you diagnose Hodgkin’s lymphoma?

A

Lymph node biopsy with histological confirmation
FBC
CXR, CT/MRI
Bone marrow biopsy, functional isotopic scanning

Covo's KFP q's (1 decks)

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