GP Flashcards
Name 3 health professionals who look after children until the age of 10.
community midwife: pregnancy and few weeks after birth
community health visitor: until the age of 5
school nurse: 5 to 10. does the hearing vision test.
Name 3 things recorded in the Personal Child Health Record or the red book.
Height
Weight
Vaccinations
What are the main concerns to look for in a NIPE screening programme for newborns or infants?
Congenital Heart Disease
Developmental Dysplasia of the Hip (DDH)
Congenital cataracts
Undescended testes
What are the common sites for osteoarthritis?
Weight bearing joints
Knees and hip and spine
Give two articular features of osteoarthritis.
- loss of cartilage
2. formation of new bone
What is the typical presentation of osteoarthritis?
> 45yo
pain and stiffness in weight bearing joints
stiffness in the morning/after rest lasting no longer than 30 mins
pain and stiffness worse with movement and exercise
What are the red flag symptoms for a musculoskeletal condition?
back pain < 25yo worsening back pain >55yo Hx of cancer steroid use HIV positive weight loss structural deformities night pain and sweats saddle anaesthesia
Give examples of non-pharmacological management of osteoarthritis.
weight loss walking aids exercise and physiotherapy electrotherapy- transcutaneous electrical nerve stimulation (esp back pain) appropriate footwear
Give examples of pharmacological management of osteoarthritis.
topical capsaicin
paracetamol
NSAIDs (with PPI)
intra-articular corticosteroid injections
Describe the analgesic ladder.
Mild pain: non-opioids: NSAIDs, aspirin, paracetamol
Moderate pain: mild opioids: codeine (constipation), dihrydrocodeine
Severe pain: strong opioids: morphine, tramadol, pethidine, diamorphine, fentanyl
What are the side effects of opioids?
nausea, vomiting, constipation, drowsiness, respiratory depression, hypotension, addiction and itching
What is a characteristic side effect of tramadol?
Serotonin syndrome
What are the side effects of NSAIDs?
stroke, high blood pressure, tinnitus, peptic ulcer, indigestion
What are the possible side effects of paracetamol?
Nausea, loss of appetite, leucopenia, low blood pressure, diarrhoea.
How do you treat morphine overdose?
IV naloxone
How do you treat paracetamol overdose?
IV N-acetylcysteine
What tool would you use to assess a patient’s risk of developing cardiovascular disease in the next 10 years?
QRISK3
What does the Dipeptidyl peptidase 4 inhibitor, pioglitazone, increase the risk of?
heart failure, bladder cancer, bone fracture
What does a diabetic review involve?
Blood glucose test- HbA1c Blood pressure check Cholesterol check Eye screening Foot and leg exam Renal function test Advice on diet Emotional and psychological support Free flu jab Sexual health concerns
Name some complications of diabetes.
Neuropathy Nephropathy Retinopathy Cardiovascular disease Foot damage and gangrene Hearing impairment Skin conditions Depression
Give 3 causes of MI.
- coronary atherosclerosis
- coronary thrombus
- reduced blood flow to heart due to shock or haemorrhage
What are the side effects of corticosteroids?
immunosuppression loss of bone density mood weight gain hypertension diabetes mellitus
What would you expect to see on an X-ray of a joint with rheumatoid arthritis?
osteophyte formation
Give 3 examples of DMARDs.
Methotrexate
Sulfasalazine
Azathioprine
Why should sulfasalazine not be given to men?
reduces sperm count causing subfertility
What signs and symptoms should a patient on myelosuppressants (chemo, azathioprine) look out for?
sore throat, fever, unexplained bruising or bleeding
Define chronic kidney disease.
The presence of kidney damage (albuminuria) or decreased kidney function (glomerular filtration rate < 60 ml/minute per 1.73 m^2) for 3 months or more, irrespective of clinical diagnosis.
What are the risk factors for CKD?
proteinuria CVD AKI hypertension diabetes mellitus smoking African, afro-Caribbean, Asian family origin chronic use of NSAIDs
Describe the stages of CKD.
Stage 1: normal: >90 Stage 2: mild impairment: 60-89 Stage 3a: moderate impairment: 45-60 Stage 3b: moderate impairment: 30-45 Stage 4: severe impairment: 15-30 Stage 5: end-stage renal disease/established renal failure: <15 or on dialysis
What does renal replacement therapy include?
haemodialysis, peritoneal dialysis, chronic ambulatory peritoneal dialysis, renal transplantation
Give 3 benefits and 3 risks of transplantation.
Benefits: improved quality of life, no need for dialysis, reversal of anaemia and renal bone disease
Risks: immediate operative complications (infection, pain, pneumonia, DVT), immediate graft failure, arterial or venous thrombosis in the transplant, side effects of immunosuppressive drugs.
What are the contra-indications to peritoneal dialysis?
Abdominal adhesions, stoma, obesity, intestinal disease, respiratory disease, hernias.
What does haemodialysis involve?
Blood is drawn from an arteriovenous fistula and circulated through a dialyser before being returned to the body.
What does peritoneal dialysis involve?
A dialysate is infused into the peritoneal cavity and the blood flowing through the peritoneal capillaries acts as the blood source.
What are the risks of breast cancer screening?
overtreatment
unnecessary distress
missed diagnosis
x-ray radiation exposure during mammogram
Who is offered breast cancer screening?
Women aged 50 to 71 who are registered with a GP, every 3 years
What happens if someone has an abnormal breast screening result?
more mammograms, breast examination, ultrasonography, biopsy
Give 5 symptoms of breast cancer.
breast lump nipple colour change nipple discharge (might be bloody) axillary lumps breast pain
Give 5 risk factors of breast cancer.
Personal or family history of breast cancer BRCA-1 or BRCA-2 gene or TP53 mutation increased age obesity after menopause Increased exposure to oestrogen
What are the complications of breast cancer treatment?
arm mobility, lymphoedema, menopausal symptoms, neutropenic sepsis
What are the criteria for the genetic screening of BRCA?
More than 2 relatives who have had breast cancer before 50
relative who has developed breast cancer in both breasts
male family history of breast cancer
eastern European heritage
jewish
What is the pharmacological treatment of depression?
fluoxetine (SSRI)
marplan (MAOi)
