gp bits Flashcards
wheeze - continuous coarse whistling sound in airways indicates
asthma copd bronchiectasis
coarse crackles in lungs indicates
pneumonia bronchiectasis pul oedema
find end inspiratory crackles indicates
pul fibrosis
stridor indicates
foreign body inhalation
drug that can cause a cough
ACE-i
ssri??
selective serotonin reuptake inhib
citalopram, dapoxetine
fluoxetine
long half life so safer to suddenly stop
tcas??
Tricyclic antidepressants (TCAs) amitriptyline, nortriptyline no longer first choice as dangerous in overdose and have bad side effects
snri?
Serotonin-noradrenaline reuptake inhibitors (SNRIs)
duloxetine, venlafaxine
NASSAs???
Noradrenaline and specific serotonergic antidepressants (NASSAs)
thought to cause fewer sexual problems
mirtazapine
antibodies RF for T1DM
islet cell antibodies, antibodies to glutamic acid decarboxylase (GAD-65), insulin autoantibodies, and IA-2A, to protein tyrosine phosphatase
diabetes assoc conditions in women
polycystic ovary syndrome, gestational diabetes
gave birth to high weight baby
metformin method of action
inhibition of hepatic gluconeogenesis. Decrease blood glucose.
comps of diabetes
neuropathy - toes fingers cardiovasc disease - stroke, HA, angina, atherosclerosis nephropathy retinopathy foot damage bacterial/fungal infections of skin
annual diabetes check
foot exam- for loss of sensation, ulcers, infections
eye exam - fundoscopy
BP and signs of kidney disease
increase/decrease risk of RA in women
women more likely to have it
Women who have never given birth may be at greater risk of
developing RA
Women who have breastfed their infants have a decreased risk of developing
RA
what is RA basic
inflammation of the synovial
joints, periarticular tissue destruction
management of rheumatoid arthritis including medication,
surgery, physical therapy, mental health support
DMARD - methotrexate JAK inhib adalimumab, steroids, NSAIDs, physiotherapy occupational therapy surgery- carpal tunnel release, release tendons in fingers to treat abnormal bending removed inflamed tissue joint replacement
LUTS presenting complaint
Dysuria: typically associated with urinary tract infection (UTI), including sexually transmitted
infections (e.g. chlamydia, gonorrhoea).
Urinary frequency: commonly associated with UTIs.
Urinary urgency: may be associated with UTIs or detrusor instability.
Nocturia: associated with UTIs and prostate enlargement (e.g. benign prostatic hyperplasia).
Haematuria: associated with UTIs, trauma (e.g. catheter insertion) and renal tract cancers
(e.g. bladder cancer, renal cancer).
Urinary hesitancy, terminal dribbling and poor urinary stream: associated with enlargement
of the prostate (e.g. prostate cancer, benign prostatic hyperplasia).
Urinary incontinence: associated with a wide range of pathology including UTIs, detrusor
instability and spinal cord compression (e.g. cauda equina syndrome).
Fevers and rigors: typically associated with pyelonephritis.
Nausea and vomiting: typically associated with pyelonephritis.
Weight loss: associated with malignancy and uraemia.
Uraemic symptoms: nausea, vomiting, fatigue, anorexia, weight loss, muscle cramps, pruritis
and confusion.
autoimmune conditions that may predispose patient to renal disease
SLE, scleroderma
nephrotoxic meds
NSAIDs (eg. ibuprofen. naproxen.) ACE inhibitors (eg. Benazepril, lisinopril) and angiotensin
II receptor blockers. (eg. Azilsartan)
tests for LUTS
MSU (presence of microorganisms, haematuria, proteinuria - infection or AKI?), urinalysis (microscopic or dip test. Looks at contents of urine. is it red for blood? Foam can be a sign of kidney disease, while cloudy urine may mean you have an
infection. crystals -clumps of minerals, a possible sign of kidney stones), relevant blood tests, PSA
why ‘midstream’ urine test?
reduces the risk of the sample being contaminated with bacteria from: your hands. the skin around the urethra, the tube that carries urine out of the body
what can a dipstick test look for
acidity - ph protein glucose wbc nitrites bilirubin
lifestyle changes to reduce/manage BPH
less fizzy drinks less alcohol less caffeine
reduce fluids in evening
double voiding
eat more fibre - prevent constip putting pressure on bladder
absorbent pads
bladder training
drugs for BPH
Alpha blockers relax the muscle in your prostate gland (tamsulosin)
Anticholinergics relax the bladder muscle if it’s overactive (oxybutynin)
5-alpha reductase inhibitors shrink the prostate gland if it’s
enlarged (finasteride)
diuretics in day, desmopressins at night
BHP rf
diabetes age obesity diet high in sat fat
common diarrhoea in diff ages
children - rotavirus
adult - norovirus
define functional symptom
Functional symptoms are physical symptoms without an obvious physical cause
manage IBS
food diary to identify trigger relax - reduce stress exercise probiotics homemade meals with fresh ingred low FODMAP diet eg avoid of:fruit and vegetables, milk, wheat products. amitriptyline citalopram CBT
