GP block Flashcards
Name 3 common side effects of statins
Headache
Aesthesia (decreased muscle strength, lack of energy)
Flatulence
Which long term medication should be stopped if you start clarithromycin antibiotic?
Statin should be stopped
Statins should be stopped during pregnancy. True or false?
True
Headache red flags
Pain wakes patient up at night
Worse on coughing
3 features which are most indicative of a diagnosis of anorexia nervosa?
BMI <17.5
Distorted body image perception
Amenorrhoea
Which type of spots are associated with measles
Koplik spots
What kind of vaccine is the MMR?
- killed
- conjugate
- live attenuated
Live attenuated
A child with egg allergy can have the MMR vaccine. True or false?
True
Children with egg allergies are most likely to develop side effects to which vaccine?
Flu vaccine
which class of anti-depressants commonly have headaches and nausea as transient side effects?
SSRI
- fluoxetine, sertraline, citalopram, escitalopram, paroxetine
What is the Q-fit test?
Check for specific type of blood in stool which would suggest colorectal cancer
Which medication can cause leg swelling and breathlessness?
Amlodipine
Side effect of GTN spray (initial usage)
Thumping headache, faint feeling
- vasodilates blood vessels
Management of polymyalgia rheumatica
Prednisolone
- long course (several months)
- must titrate dose down slowly
What scoring system is used for sleep apnoea?
Epworth score
When taking a Hx from someone with suspected sleep apnoea, what is important to ask in SHx?
Does the patient drive?
Weight?
Alcohol?
Smoking?
Which antidepressant is used first line if the patient has insomnia (as the medication has a sedative effect) ?
Mirtazapine (atypical anti-depressant)
If patients get mirena coil, most of them will/will not have periods?
85% will not have periods
Hard skin on foot with central punctum. What is the likely diagnosis and what is the treatment?
Diagnosis: corn
Tx: corn plasters
What are some first line treatments of anxiety?
Sertraline
Propranolol
Name 2 radiological features which could be present with rheumatoid arthritis?
Osteopenia
Periarticular Erosions
First line treatment for hypertension in patient under 55
ACE inhibitor
First line treatment for hypertension in patient over 55
CCB (amlodipine)
If a patient is started on ACE inhibitor for hypertension, when should they be followed up?
Check U+E’s 7 days after initiation of ACE inhibitor
Check BP within 1 month
Patient on ACE inhibitor for hypertension but not effective. What is done?
ACE inhibitor + CCB
OR
ACE inhibitor + thiazide-like diuretic
ACE inhibitor + CCB but BP still uncontrolled. What is the next step?
ACE inhibitor + CCB + thiazide-like diuretic
If patient is on ACE inhibitor + CCB + thiazide-like diuretic but BP is still uncontrolled, what is the next step?
Spironolactone or
beta blocker
or alpha blocker
Name 2 alpha blockers
Doxazosin
Tamsulosin
What is tamsulosin used to treat?
Prostate problems - BPH
In the treatment of BP, when should specialist help be required?
Once on quadruple therapy
A 2-year-old boy presents with a harsh cough and pyrexia. His symptoms worsened overnight and on examination stridor is noted. What is the likely diagnosis and what is the best management?
Diagnosis: croup
Treatment: oral dexamethasone
Worsening lower limb weakness following gastroenteritis think which condition?
Guillian barre syndrome
A clinical disease involving the loss of fine motor control and coordination, gait dysfunction and imaging showing cervical cord compression
Cervical myelopathy
Cervical myelopathy is UMN or LMN pathology?
UMN pathology
Disc herniation usually causes a myelopathy or radiculopathy?
Radiculopathy
Symptoms in a radiculopathy are unilateral/bilateral?
Unilateral
Symptoms in a myelopathy are unilateral/bilateral?
Bilateral
myelopathy/radiculopathy has a specific nerve root pattern ?
Radiculopathy
Radiculopathy is UMN or LMN pathology?
LMN pathology
What is the defining difference between cervical radiculopathy and cervical myelopathy?
cervical radiculopathy - LMN
cervical myelopathy - UMN
What is the preferred antiplatelet therapy for secondary prevention following a stroke?
Clopidogrel
Ataxia
Dementia
Urinary incontinence
what does this triad of symptoms make you think of?
normal pressure hydrocephalus
Acute episode of gout treatment
Colchicine
Which of the following treatments are licensed for prevention of migraine?
- amitriptyline
- propranolol
- sodium valproate
- topiramate
- pizotifen
Pizotifen
Propranolol
Topiramate
What specific monitoring is required for ACE inhibitors
Renal function, U+E
blood pressure checks
If you have never had chicken pox, you should avoid people who have chicken pox or shingles. This is true for what medication?
Prednisolone (steroids)
Allopurinol can cause rash. True or false?
True
After non-cardioembolic stroke, what secondary prevention should be prescribed? (3)
- anti-coagulant
- anti-hypertensive
- anti-platelet
- thrombolytic
- statin
Anti-hypertensive
Anti-platelet
Statin
thrombolytic drugs are for acute stroke / secondary prevention of stroke?
Acute stroke
If a patient is over 65 and requires an NSAID, what should they be co-prescribed?
PPI (omeprazole) for gastric protection
If a patient has a CVD risk of over 20% what treatment should they be started on for primary prevention?
Statin
what are the 3 triple whammy medications
ACE inhibitor / ARB
Diuretic
NSAID
Why should you give statin at night?
Most cholesterol is made when dietary intake is at its lowest (ie throughout sleeping hours)
After an MI, which medications should a patient be on acutely?
Stain
Anti-platelet
ACE inhibitor
beta blocker
What is the medication quinine sulphate commonly used for
Restless legs
nocturnal leg cramps
ACE inhibitors cause hyper/hypo -kalaemia?
Hyperkalaemia
Varenicline (Champix) is used for what?
Smoking cessation
Patient (lorry driver) with T2DM is on metformin but on annual check up has HbA1c of 62mmol/l. and BMI of 32. Should a sulphonylurea be added?
Avoid sulphonylurea - patient is a lorry driver and risk of hypo with sulphonylurea. Also sulphonylurea causes weight gain
Eye pain, lasts for days, associated with tearing and reddening of the eye. Also has a runny nose. What is the likely diagnosis?
Cluster headache
What is prophylactic treatment for cluster headache?
Verapamil
Patient with hepatomegaly and has a glass eye. What do you think of?
Metastasis from melanoma (eye)
79 M, presents with shortness of breast, there is no chest pain. He has been a lifelong smoker and is known to be hypertensive. GP recently started him on new meds to help control BP. CXR shows bilateral pulmonary oedema. What is the diagnosis?
Renal artery stenosis
- Recently started andihypertensive medication is likely to be ACE inhibitor which on the background of bilateral renal artery stenosis has precipitated flash pulmonary oedema.
In GBS, the weakness is symmetrical or asymmetrical?
Which muscles tend to be affected first: proximal or distal?
Symmetrical
Proximal muscles affected first
Pale optic discs suggest optic neuritis. True or false?
True
Type 2 diabetics medication
1st line
2nd line
3rd line
1st line - metformin
2nd line + sulphonylurea / SGLT2 inhibitor
3rd line + GLP1 agonist, DPPIV inhibitor
Bells palsy is an UMN / LMN condition?
what does this mean: partial / whole side of face affected
LMN condition
Whole side of face affected
Adenosine should be avoided in people with which condition?
Asthma
What is primary hyperparathyroidism most commonly due to?
Parathyroid adenoma
The ECG in Eisenmenger’s syndrome shows
- right ventricular hypertrophy
- left ventricular hypertrophy
Right ventricular hypertrophy
In relation to the JVP, what is kussmal sign related to?
Constrictive pericarditis
